310 8TH ST - DRIVEWAY & PATIO „f ritA CITY OF ATLANTIC BEACH
” s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
'z�011 i) INSPECTION PHONE LINE 247-5814
RIGHT OF WAY - SINGLE OR TWO FAMILY RIGHT OF WAY
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ROW17-0022
Description: New concrete and gravel driveway/patios
Estimated Value: 12500
Issue Date: 11/1/2017
Expiration Date: 1/30/2018
PROPERTY ADDRESS:
Address: 310 8TH ST A
RE Number: 169918 0100
PROPERTY OWNER:
Name: GROSHELL BENJAMIN S
Address: 107 S ROSCOE BLVD
PONTE VEDRA BEACH, FL 32082
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: URBAN PARTNERS CONSTRUCTION
Address: 4320 PABLO PROF CT STE 103 EDMUNDO ENRIQUE
GONZALEZ **
JACKSONVILLE, FL 32224
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
.SLAP fj
- r Permit Conditions
City of Atlantic Beach
Permit Number: ROW17-0022 Description: New concrete and gravel driveway/patios
Applied: 10/23/2017 Approved: 10/30/2017 Site Address:310 8TH ST A
Issued: 11/1/2017 Finaled: City,State Zip Code:Atlantic Beach, Fl 32233
Status: ISSUED Applicant: <NONE>
Parent Permit: Owner:GROSHELL BENJAMIN S
Parent Project: Contractor: <NONE>
Details:
Please email plan review comments to jw@urbanpartnersgroup.com
LIST OF CONDITIONS
SEQ NO ADDED DATE REQUIRED DATE SATISFY DATE TYPE STATUS
DEPARTMENT CONTACT REMARKS
1 10/24/2017 EROSION CONTROL INSTALLATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(247-
5814)to request an Erosion and Sediment Control Inspection prior to start of construction.
2 10/24/2017 ON SITE RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All runoff must remain on-site during construction.
3 10/24/2017 ROLL OFF CONTAINER INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapell's,Inc.,Republic Services). Container cannot
be placed on City right-of-way.
4 10/24/2017 RIGHT OF WAY RESTORATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Full right-of-way restoration,including sod,is required.
5 10/24/2017 RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
gii
Printed:Wednesday,01 November, 2017 1 of 2 r
s ' ,., Permit Conditions
vivo- City of Atlantic Beach
aJ�)
6 10/24/2017 MAXIMUM DRIVEWAY INFORMATIONAL
PUBLIC WORKS Scott Williams
!Notes:
Maximum driveway width within the City right-of-way is 20'.
7 10/26/2017 UNDERGROUND WATER SEWER INFORMATIONAL
UTILITIES
PUBLIC WORKS Kayle Moore
Notes:
Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field
coordination is needed,call 247-5834.
8 10/26/2017 METER BOX SEWER CLEAN OUT INFORMATIONAL
PUBLIC WORKS Kayle Moore
Notes:
Ensure all meter boxes,sewer cleanouts and valve covers are set to grade and visible.
9 10/26/2017 RT1 SEWER CLEANOUT INFORMATIONAL
PUBLIC WORKS Kayle Moore
Notes:
A sewer cleanout must be installed at the property line. Cleanout must be covered with an RT1 concrete box with metal lid. Cleanout to be set to
!grade and visible.
Printed:Wednesday,01 November, 2017 2 of 2 �g
.-51-Alf ,, City of Atlantic Beach APPLICATION NUMBER
JS . Building Department (To be assigned by the Building Department.)
,• - !; ;' 800 Seminole Road
,,v�'- :� Atlantic Beach, Florida 32233-5445 �GU i-7--003a.
\`., Phone(904)247-5826 • Fax(904)247-5845 r
\oril9v. E-mail: building-dept@coab.us Date routed: ' d 33 06,017
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 31 0 n si--. Department review required Yes No
Building
Applicant: 0 flo .in perir,,,s 6,efanning &Zoning
I ree Actmin1 ra or
Project: i jec„)ce+n_rekl,ret ( A �h: /Rhe Public t
QI J/ j Public tiliies
�
. 1 Leat_ �'•w�ccc
L. ?( 1 f )few ccvi.z . k *0, Public Safety
30) (3 „As-loan p.-Y-+r\ s51.0,e. ;;-h Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date -
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: /Approved. Denied. Not applicable
(Circle one.) Comments:
BUILDING
cPricl\--INING &ZO Reviewed bye Date:1 3 t
Io: Z7- i7
TREE DMIN. Second Review: Approved as revised. ❑Denied. i 'Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. Denied. nNot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
syLvf City of Atlantic Beach APPLICATION NUMBER
S r i\ Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 F.(X. ) (7--00 a ati
Phone(904)247-5826 • Fax(904) r 247-58VL�
01119%- E-mail: building-dept@coab.us 1 2 3 20 Date routed: [ 0/33/a01,7
City web-site: http://www.coab.us 11
APPLICATION REVIEW AND TRACKING FORM
Property Address: 31 v j i•-- Department review required Yes No
Building
Applicant: Ocbat-pc,r-EneS 6,z„,,, fanning &Zoning
free AarTitnistra or
Project: kyt.do c 4c/9r ( A� /R�f <Publi r
I J Public tilities
l
?
A\ -62cY_ e--EW41 t f(Cal 1'C )1 eW CcP vv-e_i1't Public Safety
loan par�rlet-So i Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date -
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: 7(pproved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: r Date: 7 2V"/7
TR ADMIN. Second Review: Approved as revised. ❑Denied. flNot applicable
• BLIC WORK Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. I ]Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
City of Atlantic Beach APPLICATION NUMBER
srj( IJ
,t� Building Department (To be assigned by the Building Department.)
800 Seminole Road
__ _ Atlantic Beach, Florida 32233-5445 � � j 7 OOaa.
A
Phone(904)247-5826 • Fax(904)247-5845 OCT\,,31tr E-mail: building-dept@coab.us 3 op Date routed: 0/33/6.0t 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 31 0 841 Department review required Yes No
Building
Applicant: U fijcaal parInerS 6rzu_le fanning &Zoning
Tee AdmTiistra or
Project: Co, ` i�'c�`' ��„1 . ., , 146 Public rl
- � Public Utilitie�
� t l P(ctn 1ew cc %-)vt.-*Jtt`J D Public Safety
Fire Services
J/a) ( tu--6,1r)
Review fee $ z Dept Signature
Other Agency Review or Permit Required Review or Receipt Date -
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: proved. Denied. nNot applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: / �'�' Date: /072 4/77
TREE ADMIN. Second Review: ['Approved as revised. ❑Denied. ❑Not applicable
PU:. �s..e.:.��+Com •nts:
' BLIC UTILITIES -
-
/-7
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. ['Denied. I INot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
c
't Building Permit Application Updated 5/5/17
`i City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
"°';'fr Phone: (904) 247-5826 Fax: (904) 247-5845
II\
Job Address: 31d U 64- Permit Number: ROW 11- c
Legal Description �-CR7 /62-ZS'zei.� /141A.41,1_ gc4cY` Lot3 Stic I RE#
Valuation of Work(Replacement Cost)$ 177 600 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): e3 Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): CommercialResidential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
deg,) Cancce- CSL futa mat or;Jevai7Pckiios
Florida Product Approval# for multiple products use product approval form
Property Owner Information\ �J
Name: - iell' .aM+n S a-co4 t \ 7I$& Gco56/Address: l07 S eoscoc �I J-
City °oit eke. T. -_ State FL Zip 3ZO Z Phone_4/4
E-Mail (Jff
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information ror ptav fico- i fcrbetvlPu-i-enrrssremp,604
Name of Company: 1AfA0o.tl\ ;•\r1-,ners &c0,1 Qualifying Agent:
Address 3Z3tp eoL.,k ViyL, City Jcta.se•r1V llt State FL Zip 32-ZO7
Office Phone CgO b .7D - ZZz6 Job Site/Contact Number eg. 312 SZ53 CJetke)
State Certification/Registration#e-c-.G.11 g 3-,g E-Mail 427.5 __________L--,,,,,,,,-,1,4,,...--m om,L..._-= . c_vr--rr,
Architect Name&Phone# 1✓1:ca-.c eJ 5,-..e.. s-uci 54--r Sch-i, -d t=C.S'•c ,-i Gore-5..1 ti Q 3 13(.?,
Engineer's Name&Phone#Ge.12.4< Cr i-4r,e.r PE ,r:%..1ecears dcr Cr—c.2 C-o, $....e4. 91vH-.. -H-3oa c
Workers Compensation (3...,•1 cJ— . �
e1,.. ."1 =1—%z....,-�.+c.e C_orr7 �.• W 1019 I loG/ 1=/1/a n
Exempt/Insurer/Lease Employees/Expiration DateGP
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CQNSUri WITH YOUR LENDE• 0 R AN ATT• •NEY BEFORE
RECORDING OUR NOT E-6 COMMENCEMENT/' i
_.........- / A,..de
(Signature of Owner or Agent) ignature • ontractor)
(including contractor)
Signed and sworn to(or affirmed)before me thisc., day of ''gned and swor .. (or affirmed)before me this . day of
c,cI-rdtblr-, .. c..?*-7,by c-4-4,t +-- , e-1,by
(Signature of Notary) (Signature of Notary)
; •s°•, TALIA DAH LK '�a° '.: 7ALIA D
Li ��� MY COMMISSION#GG 094490 MY c
COMMIS.,ION#GG E 094490
k]Personally Known OR ^, i1t. c EXPIRES.April 16.2021 �]Personally Known OR 'r ';i EXPIRES:April 16.2021
[ ]Produced Identification e ',,‘;';,0 Bonded Thv Notary Public Undenriters [ l Produced Identification tdcd TNN Notary Public Underwriters
Type of Identification: - Type of Identification: -
;3'441 rbc
�; REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of 20
by the City of Atlantic Beach,Florida,a municipal corporation organized and existing under the laws of the State of
Florida,hereinafter referred to as"CITY"and
of Atlantic Beach,Florida,hereinafter referred to as"USER".
WITNESSETH:
That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the
property for the purpose as described in the City of Atlantic Beach Right-of-Way Permit#
This work is generally described as
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to
relocation or removal on thirty(30)days' notice by CITY to USER, said notice to USER shall be given by certified mail,
return receipt requested,to the following address
• In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter
upon the above described property of the CITY, the USER shall replace at the USER's sole expense, any and all
material necessarily displaced during the action of maintaining,repairing, operating, replacing or adding to of the
utilities and facilities of the CITY or franchise utility provider.
• The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land
Development Code and all other land use and code requirements of the CITY,including City Code Section 19-7(h)
which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must
be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks."
• The USER,prior to making any changes from the approved plans and/or method,must obtain written approval from
the City of Atlantic Beach Public Works Department,for said change within 30 days after the day of completion.
• This permit shall inure to the benefit of,and be binding upon,the USER and their respective successors and assigns.
• USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or
specifications,to include utilities locate requirements and use limitations/requirements of public right-of-ways and
other public land. USER further agrees that the CITY and its officers and employees shall be saved harmless by
the USER from any of the work herein under the terms of this permit and that all of said liabilities are hereby
assumed by the US R.
Date /Sd /'
Pr, I •rty Owner/Agen (signed in - I
g ( gn p e of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this .c. day of e=..,crr 20 1 --I
by L .:Z G GC.... )-•-,e.t % ,who personally appeared before me and
(printed name of Signer)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
Signature of Notary Public, State of Florida
Approved/Public Works Department:
Personally Known ,(
Produced Identification T . 21-11.
-
TALIA DAHLKE
r°R MY COMMISSION#GG 094490 //��� -r
�� Scott tlltams
•.<: EXPIRES:April 16,2021 �e�r'ublic Works �irector
••„;1,ite Bonded Thni Notary Public Underwriters
RIGHT-OF-WAY/EASEMENT PERMIT
M _
019,„
- r Permit#Issued by the City of Atlantic Beach '1 it
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address 31 v g4-4-, 5.4-. ,o.B.) c) Phone g3& `ov,55
Peiinittee � C"s�c,5{-,moi 1 Email 1
C'
Requesting Permission to Construct pri✓e vu9t.i
Location(Reference to Cross-Street)
• Permittee declares that prior to filing this application they have ascertained the location of all existing utilities,
both aerial and underground and the accurate locations are shown on the sketches.
• Whenever necessary for the construction,repair, improvement, maintenance, safe and efficient operation,
alteration or relocation of all,or any portion of said street or easement as determined by the Director of Public
Works,any or all said poles,wires,pipes,cables or other facilities and appurtenances authorized hereunder,shall
be immediately removed from said street or easement or reset or relocated hereon as required by the Director of
Public Works and at the expense of the Permittee unless reimbursement is authorized.
• All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed
under the supervision of ..J Ke.. wi G., cis erie3J 512, -SZ5� (Project Superintendent)
located at 373/0 l l!vd J�ko41/://c, rL
• All materials and equipment shall be subject to inspection by the Director of Public Works.
• All city property shall be restored to its original condition as far as practical, in keeping with City specifications
and the manner satisfactory to the City.
• A sketch of plans covering details of this installation,as well as a copy of a recent survey shall be made a part
of this permit. Calculations showing any increase in impervious area on owner's lot or in the City
right-of-way are to be included with this application.
• The permittee shall commence actual construction in good faith within H days. If the beginning date is more
than 60 days from date of permit approval then permittee must review the permit with the Director of Public
Works to make sure no changes have occurred in the area that would affect the permitted construction.
• It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's
right,title and interest in the land to be entered upon and used by the holder, and the holder will, at all times,
assume all risk of and indemnify,defend and save harmless the City of Atlantic Beach from and against any and
all loss, damage and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of
the aforesaid rights and privileges.
• The Director of Public Works shall be notified twenty-four(24)hours prior to starting work and again
immed' ely upon • pletion.
� r /
Date ' a•—ea •a—i
Pe tee(signed in presence of Notary ' I lic)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this day of o c-- ,20 i —'1
by 1— ,who personally appeared before me and
(printed name of Permittee) _
acknowledged that he/she signed the instrument voluntarilyfor thepurpose expressed in it. "'a+` COMMISSIONTALIA #0
p ��•, .�= MY #GG 094490
1.:,;,1 EXPIRES:April 16.2021
‘.",:f.17,1tcY Bonded Thru Notary Public Underwriters
Personally Known 4�r
Signature of Notary Public,State of Florida Produced Identification(Type)