1895 HICKORY LN - DRIVEWAY ,,;s1-44:r ,
�s ' �
: '' >` "� CITY OF ATLANTIC BEACH
14 P > 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
--o13 v. INSPECTION PHONE LINE 247-5814
DRIVEWAY - SINGLE OR TWO FAMILY DRIVEWAY
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: DWAY17-0025
Description: 2 DRIVEWAYS AND SIDEWALK- PAVERS
Estimated Value: 19000
Issue Date: 1/11/2018
Expiration Date: 7/10/2018
PROPERTY ADDRESS:
Address: 1895 HICKORY LN
RE Number: 172020 1326
PROPERTY OWNER:
Name: ZAZZARINO EDWARD
Address: 1895 HICKORY LN
ATLANTIC BEACH, FL 32233-4548
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: CITYSTONE, INC
Address: 9339 CRAVEN ROAD
JACKSONVILLE, FL 32257
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.
City of Atlantic Beach APPLICATION NUMBER
(r/1-tvp„,,
o Building Department (To be assigned by the Building Department.)
- - • _ 800 Seminole Roa32233-5445 A� 17 _ 002,s
Yi..
Atlantic Beach, Florida 32233 5445
Phone (904)247-5826 • Fax(904) 247-5845
• 61119'1-• E-mail: building-dept@coab.us Date routed: CD13 ( J I
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: j� B �" t Lao rY L� Department review required Yes No
Building
Applicant: a L S�s'1 I anning &Zoning
Tre' dministrator
Project: pAverz_. -
izveLos C/ ._ blic Works )
/ Public Utilities
Pci E S l A-L t<J Public Safety
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: pproved. ['Denied.
Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by.." � — Date:/f 'fr 7
TREE
ADMIN. Second Review: A roved as revised.
n pp ❑Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. fNot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
i :-& City of Atlantic Beach APPLICATION NUMBER
J3 i\ Building Department (To be assigned by the Building Department.)
r 800 Seminole Road �\\ _ ���
�� Atlantic Beach, Florida 32233-5445 AL(���, Phone(904)247-5826 • Fax(904)247-5845 tJI''
\0;3 9%' E-mail: building-dept@coab.us )���� Date routed: I 0(3 ( i i 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: L Sci s 14 l (' kory LC\ Department review required Yes No
l
( Building
Applicant:pertyS e.,_,_ A�Cnning & g Zoning
Tree Administrator
Project: — ,/,
�.Ve(,„ (z) _ ublic Works
Public Utilities
Al"DS l (Yel/3 A-L -S Public Safety
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: I V Approved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
'
PLANNING &ZONINGReviewed b 441;rr4,2 ' Q Date: //i)/7
TREE ADMIN. Second Review: ❑Approved as revised. ['Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ['Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
% Building Permit Application Updated 5/5/17
r $ ' City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
sfr Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: ,��,�fi'-8 g5-DlH� /C f.O R-y ,r<,4 V acePermit Number:
Legal Description R�% I tic C tarn PRIV5t1I7 I0 F,WegS RE#
Valuation of Work(Replacement Cost)$ // OOD- Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No N/A
• 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: pot/love,- 5 /9Ey474-(,k p 2 Piuveithq..
1y 7v
1 tis C L piwoaS - 3 c e- wz-- ivvvve-
Florida Product Approva # . �" for multiple products use product approval form
Property Owner for ation
Name: PilbST Z/9 ZZ iRiItf,0 Address: /g9,5 h'/CAeoy t N
City t}�'l,ijt/r7 s State F� Zip 32,233 Phone) 02 yQ- y0232
E-Mail PAT ZZ 1(JNO
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information a
7
Name of Company: CI 5 NC- /A/C Qualifying Agent: t 14 21/4/Ghb/N /GG4 /
Address 9 33 9 CR t c ,P City State fL - Zip 3Z S ?
Office Phone 904_ g 75-(2 /7ey Job Site/Contact Num 90y- 759-O y 7f(
State Certification/Registration# Q¶SQ0003/592 E-Mail OFf/LG /T)'-5Toitie
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation
Exempt/Insurer/Lease Employees/Expiration Date
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, CONSULT WITH YOUR LENDER OR AN ATTORN Y BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
arst.e.t.4)' //l&fif!
(Signature of Owner or Agent) (Sig :ture of 4 ntractor)
(including contractor)
Si ned and sworn to(or affi ail,before me this day of Si ned nd sworn to(o affir es beIgre • this3 ( d•y of
ZC(7,by A.... c'. S 20 (7 ,by f? \` •.r, r� a 1_4_24b
1/11121.1 h/0
(Signature of Notary),... ,
(Signature of Notary)
DIY TOtrl IP:l1Lt
EXPIRES.October 6,2019 MY COti"J!SSIG; t
[
]Personally Known OR "T. Public Underwriters EXPIRES:October 6,2019
]'Produced Identification [ ]Personally Known OR r. Y_edrnr ^:o:anPd!!ct6.1 raters
�. o 4-1-Produced Identification '
Type of Identification: I`�t Z(dU'&, ► 5— t S-C) - ype of Identification:
MAP SHOWING SURVEY OF
LOTS 1.2 AND 13 , SELVA MARINA UNIT NO. 12-B, AS RECORDED IN PLAT BOOK 36 ,
PAGE 76 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
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REVOCABLE ENCROACHMENT PERMIT
M
REVOCABLE ENCROACHMENT PERMIT 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.
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 USER.
I9)-atT/Lt.,cr Date '1 (3/3 I I f 7
Property Owner/Agent(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this 3 ( day of 0 ,20 ( 7 ,
r ^ I�
byP4A--v_t('a a. k l `e ,who personally appeared before me and
•tinted name of Signer)
ackno :ed that hi s'I ed the inst ment voluntarily for the purpose expressed in it.
0
Signature of Notary Public,State of Florida
Approved/Public Works Department:
Personally Known
Produced Identification(Type) L. j.4#14 /1"/1 -
--4/gA
TONI GINLESPERGER� MY COMMISSION 8 PP 924951 Scottiams,Public Director
'..;:.. ."4--,,...i.4 EXPIRES:October 6,2019
'71',.;<:•-,.F�,` Bonded Thr,Notary Public Underwrters
A •
RIGHT—OF—WAY / EASEMENT PERMIT
111,11r- Permit Permit#Issued by the City of Atlantic Beach
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address /WS ff/C-Kogi 4 eraf'NTIC Bch i,L Phone 104i-375-9.280
Permittee
Email
Requesting Permission to Construct RE/Put)JE 51p6141/ k .AivP 2 PQIUE'IUfry ge j ce. Fi)x P1'6
Location(Reference to Cross-Street) CC)# W-Y`. q,C 1 q Tit ST- W(T Hick I y 442
• 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
(Project Superintendent)
located at
• 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 days. If the
than 60 days from date of permit approval then y beginning date is more
l
Works to make sure no changes have occurred in the area that would affectthe pemitted oermit with the Director of
• 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
ad24,01,
immediately upon completion.
/0/ //7
Permittee(signed in Date �
( gn presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL _r(
The foregoing instrument was acknowledged this t
day of C)o_-* 7
20
by Q+Pt e A. Dk o_k et- ,who personally appeared before me and
(printed name of Permittee)
ac 4 . edg-, ' at h, she sit. ed the instrument voluntarily for the purpose expressed in it.
ll)
—4 Personally Known
ignature of ' ry Pu•lic, State o 1 ,lprt•2.951 Produced Identification(Type) A c (p b -69 S 45 -84 Z__
EYPiRES Oc
�erv!i;er
6ondco Thr_Notary Pdol.