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596 N Nautical Blvd - Fence Permit CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 FENCE WALL OR BARRIER - FENCE MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: FNCE1 8-0027 Description: 6' FENCE Estimated Value: 0 Issue Date: 4/6/2018 Expiration Date: 10/3/2018 PROPERTY ADDRESS: Address: 596 N NAUTICAL BLVD RE Number: 1707030346 PROPERTYOWNER: Name: BLACKWELDER JOHN W Address: 596 NAUTICAL BLVD N ATLANTIC BEACH, FL 32233-4119 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: Address: 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. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. * 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 Building Department (To be assigned by the Building Department.) 800 Seminole Road i 8-(D ua7 z Atlantic Beach, Florida 32233-5445 FNc-k- Phone(904)247-5826 - Fax(904) 247-5845 Date routed: E-mail: building-dept@coab.us City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: C_ Department review required Yes No ��nr�ing &Zoni-g*- Applicant: 9� Tree Administrator Project: C_7z' �5FIFVVOY M_�" (_<F-u�blicUti i�i _. Public 9afMy----_ 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. ViDenied. []Not applicable (Circle one.) Comments:IMV-5)' 1�e BUILDING PLANNING &ZONING Reviewed by:/'_�_ Date:3-2—6- 1 TREE ADMIN. Second Review: []Approved as revised. OlDenied. []Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: [:]Approved as revised. []Denied. ONot applicable Comments: Reviewed by: Date: Revised 05119/2017 MAR 2 9 2018 CITY OF ATLANTIC BEACH 800 Seminole Road Atlantic Beach,Florida 32233 REVISION REQUEST CORRECTIONS TO PLAN REVIEW COMMENTS :01 fL Date Revision to Issued Permit Corrections to Commentsz Pen-nit# 36161' A '31x9v Project Address &4AJ� f Contractor/Contact Name 8-64v%&�La—ek- Phone A6-74673 Email A014dLfic (1-2 Description of Proposed Revision/Corrections: Permit Fee Due$ Additional Increase in Building Value $ Additional S.F. ,J,911,V A,11jA1J4--J,0e& By signing below,I affirm the Revision is inclusive of the proposed changes. rinted name) 3We Signature ok-OrCW(Contractor must sign if increase in valuation) Date (Office Use Only) Approved Denied Not Applicable to Department Revision/Plan Review Comments Department Review Required: I Buildiiin , lanning &Zoning Reviewed By nis rator o rks t rks Public Utilitie Public Sa ety Date Fire Services (DESCRIPBLOON: MAP OF BOUNDARY SURVEY L 0 T7 I C LOT 1. BLOCK 3, OF "SEASPRAY" ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 35, PAGES 64, AND 64A OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. % :%�."".'.'.': .............. ............ .......... ................ ............. ............ ........ .. .... .................. . ........ . ..... ....... ORIVE(60 .......... ................................... ........... .......... ...................... .......... ........ ........... ................... ........ ................... ........... ........... ................... .................... ......... ........... . ............. :MIAMI Ctw ............... .......... .............. L16HT PILE ........ N,3-41-00'E Lo TE SIDEWALK FOM 4' C 4' WOW PAIL F&WE F.I.P.. 14. NO 7* uj: 4'C.L.F. 6'N.F. 42.0 9'xla' n I NOW N DRIVE"; - DECK A'. LOT I ....... .... ....................... 2.0 BLOCK 3 COVERED N. CDMCRETE ....... AIC CONCRETE ............ WELL 3 61 M.F CABLE x Ln 99.69. (m) Box '14-00-E Ip) F.1.P. 314' 0.1, N83 100.00 so ID m FIP 112' C� 10 LOT 2 BLOCK 3 SURVEY MTE� COMML NITY DEVELOPMENT ff BEARINGS ARE BASED ON PLAT WITH THE SOUTH LINE OF LOT 1. BLOCK 3. BEING N83*14'00'E. CERTIFIED TO AND FOR THE Af: IS WERE NOT LOCATED BY THIS SURVEY. PFiOVED 12 UM0ERC4?0LJND UTILITIES. FOWDATIONS OR OTHER EXCLUSIVE BENEFIT OF.' IMPROVEWN J?Ow N BLACKWELDER 03 ACCORDING To THE FEDERAL EMERGENCY MANAGEMENT AGENCY WESiCOR TTTLE FIRM MAP PANEL NO. 120075 0001 0. EFFECTIVE 04117189. COM*UNrTY FIRST CREDIT UNION OF FLORIDA THE PROPERTY DESCRIBED HEREON APPEARS TO LIE IN ZONE _X'_ FIRST COAST TITLE SERVICES. INC. f4 THIS SURVEY PEwawp WITHOUT BEAEFIT OF AN ABSTRACT, STREET ADDRESS. TITLE SEARCH. TITLE OPINION OR TITLE INSURANCE. #5 OINENSZONS ARE SHOWN IN FEET AND DECIMALS THEREOF 596 NAUTICAL BOULEVARD NORTH ATLANTIC BEACH. FLORIDA AND ARE PLAT AND MEASURED UNLESS SHOWN OTHERWISE- 06 ALL EASEMEMrS ARE PER PLAT UNLESS SHOWN OTHERWISE. 17 THERE MAY BE ADDITIONAL RESTRICTIONS THAT APPLY WHICH ARE NOT SHOWN ON THIS SURVEY WHICH CAN BE FOUND IN PUBLIC RECOAW OF SAIDT COUNTY. le THIS SLOVEY DOES NOT GUARANTEE OWNERSHIP. N-MADE ITEMS SCALE: 1" 30' f9 TEMPORARY. NON-PEFAANENT IMPROVEMENTS AMIOR MA 0 SUCH AS. BUT NOT LIMITED TO THE FOLLOWING. BUILDING 14ATERIAL 0 STORAGE PODS� PAVER BLOCKS. RAWERMAIO OR PLASTIC UTILITY 0 BUILDINGS NOT ON FOLINDATIONS. VEHICLES on BLOCKS MAY BE ON THIS PROPERTY BUT NOT LOCATED OR SHOWN. fJO LEGAL DESCRIPTION PROVIDED By CLIEMT� oij BUILDING RESTRICTION LINES AM PER PLAT AND ARE 20' FROM STREET LINES. NOTICE OF LIABILITY: THIS SURVEY 15 CERTIFIED TO THOSE INDIVIDUALS SHOWN ON CLY 0. VAN KL VEYOR AND MAPPER 2546 -THE FACE TwREoF. ANY OTHER USE. aaffu OR RELIANCE By ANY OTHER PARTY IS FLORIDA REGISTERED STRICTLY PROHIBITED AND RESTRICTED. SURVEYOR IS RESPONSIBLE ONLY TO THOSE MICHAEL C. FLYNN CERTIFIED AND NEREBY DISCLAIMS ANY OTHER LIABILITY AM tfREBY RESTRICTS THE FLORIDA REGISTERED&LA7MWYOR AND 3281 RIGHTS OF ANY OTHER INDIVIDUAL OR FIRM TO USE THIS SURVEY. wrTHour ExppEss NOT VALID WITHOUT THE SIGNATMWE G THE DRY INAL RAISED WRITTEN CONSENT OF TmE SURVEYOR SEAL OF A FLORIDA LICENSED SURVEYOR AND MAP -OVERHEAD F.-CNA IN L ElLfrF CE F NCAErE MOM.WNT PC. _or'E A, TroAE WC--SECTION FEN F CONC PO NG.XT TOWNSHIP CLR El 'WP_ F :C: PDIZTT OF CtWArL'lE RSE-RANGE FAV FOEAND Cf:al..=Fe A, CC:OR:C. IF IRON.00 AMO CAP P 'EV1.0 PIPE U:E- UTITLI T ROD PEL"EVATZON M.N.-HATS METER F:'I TY EASEMENT P.1. POINT OF INTERSECTION E(Pt I S.1.A.C. SET Inum ADD AND CAP 0 E.G DRAINAGE EASEMENT AIC AIR CONDITIONING UNIT B&C. CONCRETE F C s Cum 4c GUTTER NTS NOT TO SCALE M.P.-MODO POLE F.M&O FOLM MAIL AND DISK FVX E�SMT EASEMENT P 5 M-PLAT 6 MEAStOIED FIELD MEASiMMENT RIGHT SEO C'jL CEN OF WAY (PA) TING 0 0 T ExpRZ(s)PO COR COQvER K4#-MANHOLE (C) CALCLLATEO MEASLAEMEN TERLINE (E) J /'-�PPQJECT�INFOP�MATION RvEy FIRST COAST LAND 7412 F'EL" �su OATE OPDER NO: I PLOT PLAN DRAWN BY: MCF BOUNOARY 5-13-08 SURVEYING, INC. z REVI B Y., TNP I8__ L -32-10 FORMBOARO 839 LANE AVE. S. SUITE 105, JACKSONVILLE.FL.3221 P E H02E (904) 779-2052 FAX (9041 779-7784 \,,F I N A L E TIFICATE NO. LB 7261 CER tv v oil Ic 63 Building Permit Application Updated 12/8/17 City of Atlantic Beach 800 Seminole Road,Atlantic Beach,FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 JobAddress: .5% "1177,49BUIZ11 N. —PermitNumber: Legal Description RE# Valuation of Work(Replacement CostY$ t�4�,W-04 Heated/Cooled SIF. Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door • Use of existi ng/p ro posed 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: Florida Product Approval# for multiple products use product approval form Property Owner Information Name: 1014N Address: zriqyc�� &ao /V Cib State zip -3-72 Phone OeK-,44�- 7,093 E-Mail hawsme, tv, aAlt;l 40�h Owner or Agent(If Agent,146er of Attorney or Agency Letter Required) Contractor Information Name of Company: Qualifying Agent: Address City State Zip Office Phone Job Site/Contact Number State Certification/Registration# E-Mail Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Exempt/I rer Lease Employees Expiration Date Application is hereby made to obtain a permit to do the v�ork and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and t h;"work will be performed to meet the standards of all the laws regulationg construction in this jurisdiction. I understand that a s parate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS, WELLS, POOLS, FURNACES, BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and there may be additional permits required from other governmental entities such as water management districts,state agencies,or federal agencies. 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 ATTORNEY BEFORE RECO E OF COMMENCEMENT. Si re of Owner or Agent) (Signature of Contractor) (including contractor) hi Z�d a y o Signed and sworn to(or affirmed)befor�eis day of ned and sworn to(or affi )before meA i -L'�N, by nk eC�6 'n �4 U 1—1 by I_1y CL4 - ,(Signature of Notary) TONI GINDLESPERGER�7 (Signature of Notary) MY COMO SSION#FF 924951 EXP Octob kilp Uzi? wn OR eh; Personally Kno �;.W. X=b erwnters Produced identification Ope of Iden tification: Type of Identification: _122-1-1, CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDAVIT 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE—OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER T14E CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES, 11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/CIR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(l). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826) IF IN DOUBT. V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. 111407ww 1%Y j N_ AM . 16 3�-a3l' /-70 2.51 ADDRESS I I PHONE NUMBER Jovu wr, IVEL x PRINT NAME SIGN7(�� DATE' Beforemethisc'�t' dayof V"Q-0it"N .20t " _L_oi the county of Duval,State of Florida,has personally appeared herin by himself herself and affirms that all statements and declarations are true and accurate Notary Public at Large,State of County of vc�_ 0 Personally Kno-n El Produce,Iden"'.ti.n TON]GINDLESPI GE 9 MY COMMISSION#�'F 2�1,951 Notary Signature: EXPIRES:October 6,2019 Bonded Thru Notary Public Underwriters FALDG/0�er-Builder Affadavit;REVISED. 4/16/2009 P�_ MAP OF BOUNDARY SURVEY 0 CES C R I P B L 0 N. LOT 0 LOT 1. BLOCK 3, OF "SEASPRAY- ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 35, PAGES 64, AND 64A OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. .......... ................. -;........... ................................ ........ ................------------ ..................................... ........... ----------- ..................... ........... ...... ....................... ...................... ......... .................. ............. .... ................. ..... ....................... ....... ........ x4" .................. ...... ...-...........I ............. ............. L LIGHT--, IGHT _:....... POLE ...... ..... -.... ..... ............ W,3-,j-00'E IN ............ ...........- .............. ........ X-CUT .......... ........... C3--E, 0 4'WOOD A 6 AAIL la"CE F.I.P no 10 21.7* 4'C.L.F. W.F. N 9 dal -CC WOOD ..... .... LOT I 2.0 . .......... BLOCK 3 ..................... COVERED CONCRETE ............ ............ .................. A/cj . .... .......... ............ 29.0 ...................... Zo ............... ........... MEL ........... CABLE W.F- m 69'1(m) aox F.I.P. 314 4-00-E 99- ox N83 100.00- (p) to a F I P I 10 LOT 2 BLOCK 3 tz SURVEY NOTES.* ff BEARINGS ARE BASED Of?PLAT WITH THE SOUTH LINE OF LOT 1. BLOCK 3. BEING N83*14'00 E. CERTIFIED To AND FOR THE 02 UNDERGROUND UTILITIES. FOUNDATIONS On DINER EXCLUSIVE BENEFIT OF.' IMPROVEMENTS WERE NOT LOCATED By THIS SURVEY. JOHN H. BLACKWELDER P3 ACCORDING TO THE FEDERAL EMERGENCY MANAGEMENT AGENCY MESTCOR TITLE FIRM MAP PANEL NO. 120075 0001 0. EFFECTIVE 04117189. COMMUNITY FIRST CREDIT UNION OF FLORIDA THE PROPERTY DESCRIBED HERE014 APPEARS TO LIE IN ZOUE -X FIRST COAST TITLE SERVECE& INC. f4 THIS SURVEY PERFORMED WITHOUT BENEFIT OF AN A6STRACr, STREET ADDRESS.' TITLE SE-ARCK TITLE OPINION OR TITLE INSURANCE- r,96 NAUTICAL BOULEVARD NORTH f5 OINENSID145 ARE SHOWN IN FEET AND DECIMALS THEREOF ATLANTIC BEAM FLORIDA AND ARE PLAT AND MEASURED UNLESS SHOWN OTHERWISE. f6 ALL EASEMENTS APE PER PLAT UNLESS SHOWN OTHERWISE. 17 THERE MAY BE ADDITIONAL RESTRICTIONS THAT APPLY WHICH ARE NOT SHONH ON THIS SURVEY WHICH CAN BE F0LXqO IN PUBLIC RECORDS OF SAID COUNTY. 16 THIS SURVEY DOES NOT GUARANTEE OWNERSHIP. SCALE: 1" 30 19 TEMPORARY. UON-PERMANENT IMPROVEMENTS ANDIOR PAN-MADE ITEMS SUCH AS. BUT NOT LIMITED TO THE FOLLOWING. BUILDING MATERIAL. STORAGE PODS. PAVER BLOCKS, RUBBERMAID OR PLASTIC UTILITY BUILDINGS NOT ON FOUNDATIONS. VEHICLES ON BLOCKS MAY BE ON cd THIS PROPERTY BUT NOT LOCATED OR SHOWN. flO LEGAL DESCRIPTION PROVIDED By CLIENT. 11 BUILDING RESTRICTION LINES ARE PER PLAT AND ARE 20- FROM STREET LINES. CL D. VAN KL NOTICE OF LIABILITY: THIS SURVEY IS CERTIFIED TO THOSE INDIVIDUALS SHOWN ON 546 THE FACE THEREOF. ANY OTHER USE, BENEFIT OR RELIANCE BY ANY OTHER PARTY 15 FL IDA REGIS 0 SURVEYOR AND NAPPER - 57RICTLY PROHIBITED AND RESTRICTED. SURVEYOR IS RESPONSIBLE ONLY TO THOSE MICHAEL C. FLYNN CERTIFIED AMU HEREBY DISCLAIMS ANY OTHER LIABILITY AND HEREBY RESTRICTS THE FLORIDA REGISTERED SURVEYOR ANWD 0. 261 R16HTS OF ANY OTHER INDIVIDUAL OR FIRM TO USE THIS SURVEY. WITHOUT EXPRESS NOT VALIO WITHOUT TIC SIGNATURE 8 THE OPT INAL I h-PITTEN CONSENT OF THE SURVEYOR. SEAL OF A FLORIDA LICENSED SURVEYOR ANVO E . ONE -OVEFREAD ELECTRIC SEC-SECTION FEN FENCE F.C.N. FOUND CONCRE7F H&AVENT C.R. CONCRETE AID ENT C L F-CHArN LINK FENCE I F,I P C FDL20 ZRON ROO AM CAP P T POINT OF TANGENCY Imp-TOWNSHIP CLP CLEAR W:F:-x000 rEwcE F 1:R: FOUND IRON Poo P:C: POINT OF'CURVATURE PGE-RAIME FNO FOUND BEARING EISEMENT P.1. Paz INTERSECTION IP) p C a a .. NT OF LAI W:UCHMAOTAS METER CSE;NT AIC AT;? COC ELEVATION W.P� F:I-P. FOUND IRON PIPE E': CONDITIONING UNIT EL KOOD POLL, . . .' SET IRON POO AND CAP G -LE S I n C. I SC- CONCRETE F.NGO FOUND NAIL AND DISK C C CURB c UTTER NTS NOT TO ESNr EASVIENT MEASURED OF WAY T 19) CIL (E) EXISTING M= FIELD HEASUREMW nrr�T r MR) PROPOSED p CEN - CDR CORNER MIH- E (c) CALCULATED MEASUREMENT TERLTIL PROJECT INFORMATION FIELO SURVEY OATE 0 FIRST COAST LAND ORDER NO: 17412 PLOT PLAN 0 y DRAWN BY. MCF OUNDARY 5 SURVEYING, INC. 0 9 L Z 0 -5 E Ij REVIENED BY: TNP FORMBOARO 1839 LANE AVE. S. SUITE 106. JACKSONVILLE FL.32210 OU TIC) NE FOUNDATION pHONE (904) 779-2062 FAX 1904) 779-7784 Tj cER _ L PF CERTIrrCA TEND. LB 7261 TNAL q Aill, City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road 0 ffa7 Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 3 z 0 E-mail: building-dept@coab.us LDate routed: City web-site: http-://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1�)80-CiCAc_ Department review required Yes No �Tlanning &Zonin- Applicant: CA'A g_ (. Tree Administrator Project: L�7 C-7— Of_�Ic �®r __) ,gru_�blicUti i�i3 P 7� ublic a 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: P Ot 1h ?c)A. Oe m Lod. (=BUILDING:) PLANNING &ZONING Reviewed by: /77 Date:3/P6J_20/e TREE ADMIN. V Second Review: P(Approved as revised. Denied. ONot applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by--_/71�' Date.-Y/; Of '12 FIRE SERVICES Third Review: []Approved as revised. E]DeAid. []Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 MAR 2 9 2018 Or ATLANTIC BEACH 800 Seminole Road J OFFICE COPY Atlantic Beach,Florida 32233 REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS Date. 0 V—/6 Revision to Issued Permit Corrections to Commentsz Permit# Project Address &4�J� A 610, AX930 Contractor/Contact Name— Phone_��- A�- 7973 Email Description of Proposed Revision/Coffections: Permit Fee Due Additional Increase in Building Value $ Additional S.F. By signing below,I f affirm the Revision is inclusive of the proposed changes. (printed name) 1'2r Signature 01-�t�o(Contractor must sign if increase in valuation) Date (Office Use Only) Approved Denied Not Applicable to Department Revision/Plan Review Comments 113ppartment Review Required: Buil in lanning & Zoning iewed By nis rator 61V orks Public Utilitie Public Safety Date Fire Services !.bx AJ'\- City of Atlantic Beach APPLICATION NUMBER Jr) u ing Department (To be assigned by the Building Department.) 800 Seminole Road FN 7 9 flantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845M 2 3 2 0113 '69e, E-mail: building-dept@coab.us L_2ate routed: Cityweb-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: C_ Department review required Yes No Applicant: I ning &Zoin61L� Project: Tree Administrator 9Eu--b I i�r_ U t i i�i Public 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. VDenied. []Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:-1'�',0JWzz 4&U46 D@te:_L2'p'/.&9 TREE ADMIN. Second Review: [PfApproved as revised. ODenied. []Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed bv: )'z//zW'�4ate: 40 FIRE SERVICES Third Review: []Approved as revised. ODenied. []Not applicable Comments: Reviewed by: Date: Revised 05119/2017 CITY OF ATLANTIC BEACH Department of Public Works 0 1200 Sandpiper Lane Atlantic Beach, FL 32233 Rw (904) 247-5834 PUBLIC WORKS PLAN REVIEW COMMENTS Date: 3/27/18 Applicant: John Blackwelder Pen-nit FNCE 18-0027 (DENIED Fence) Address: 596 Nautical Blvd. N. Site Address: 596 Nautical Blvd. N. Atlantic Beach, FL 32233 Atlantic Beach, FL 32233 Email: howsine(&gmail.com PUBLIC WORKS CORRECTION ITEMS: APPROVED � e A Revocable Encroachment Agree49nt mfddained. PUBLIC WORKS CONDITIONS OF APPROVAL: (The following comments will be printed on your permit as Conditions of Approval) • All runoff must remain on-site during construction. • Roll off container company must be on City approved list (Advanced Disposal, Realco Recycling, Shapell's, Inc., Republic Services, Donovan Dumpsters). Container cannot be placed on City right-of-way. • Full right-of-way restoration, including sod, is required. • All old fencing must be removed from job site by Contractor. Scott Williams, Director of Public Works swilliamsra,,coab.us /904-247-5834 THIS PLAN REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS Corrections and Revisions must be submitted to the Building Department at 800 Seminole Road. Revisions may not be submitted until ALL departments have completed their respective plan reviews. Revisions submitted must respond to each department review. Submittals that respond to only one or a few correction items will not be accepted. Resubmittal Notes: All revisions and changes shall clearly stand out from the rest of the drawing on the sheet as a revision by way of completely encircling the change with"clouding".The revision shall also be identified as to the sequence of revision by indicating a triangle with the revision sequence number within it and located adjacent to the cloud.The revision date and revision sequence number shall also be indicated in a conspicuous location in the title block for each sheet on which a revision for that sequence occurs. For projects still in the initial review stage and permit pending, all sheets with revisions shall be inserted into each set of drawings.The original sheets must be clearly marked "VOID" but are to be left within the set of drawings. Complete new sets of drawings will not be accepted. ADDITIONAL ITEMS MAY BE REQUIRED DEPENDING UPON NEW INFORMATION AND CLARITY OF FINAL PLANS SUBMITTED FOR REVIEW. Page 1 of 1 I-V I'M j ITY OF ATLANTIC BEACH APR 0 2 2018 MAR 2 9 2018 800 Seminole Road Atlantic Beach,Florida 32233 vjo9' REVISION REQUEST CORRECTIONS TO PLAN REVIEW COMMENTS Date ?j4 /0 Revision to Issued Permit Corrections to Commentsz Permit Project Address IYA&VZf &Wj� ;��2-30 Contractor/Contact Name Joy Phone 7973 Email C/ Description of Proposed Revision/Corrections: Permit Fee Due$ W-M-9� PXA-,r-Fy6� 8Wq Additional Increase in Building Value Additional S.F. By signing below,I 1011N affirm the Revision is inclusive of the proposed changes. ri ted name) Signature oljl--�t�(Contractor must sign if increase in valuation) Date' (Office Use Only) Approved Denied Not Applicable to Department Revision/Plan Review Comments— Dep?lrtment Review Required: Buil in Planning & Zoning nis rator orks Public Utilitie Public Safe D(a Ive Fire Services REVOCABLE ENCROACHMENT AGREEMENT REVOCABLE ENCROACHMENT AGREEMENT 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 ,J010 B44CM444EA 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 fujaN& 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 04 X — Z* 3->-�33 - • 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 easement or 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 easements, 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 here R. Property&v�nX�!�gned in presence of Notary Public) Date 0,�Ag STATE OF FLORIDA,COUNTY OF DUVAL The foregoing instrument was acknowledged this C1 day of P-c-((, 20 .,7 \ by CA 44 who personally appeared before me and (printed name of Signer) acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. Sign�ure of Notary Plu&ic, State of Florida Department Approval: Personally Known Produced Identification(Type) L it L fi-(\&4� Sc— otf*il fiZis�Public%`orl�s Direc r JENNIFER JOHNSTON JL MY COMMISSION#GG 0429M Kayle Moore,Public Utilities Director \Pub��9�"fr*71R?Wable ncroachment Agreement(2018).docx N.t.,y Pubk Un&vdt... e I i ". e City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road -a7 tlantic Beach, Florida 32233-5445 MAR 23 2018 FN Lc-_( E Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us L__�ate routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: /�Q' 1\JAp-r1C Department review required Yes No C Applicant: Ct 51��ning &Zon_i—ng_,, Tree Administrator Project: ___�__Ic—�_or Public"9_a'R�tT----- 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: ElApproved. E]Denied. WrNot applicable (Circle one.) Comments: BUILDING PLANNING &ZONING 3)/2_7 Reviewed by: Date:_ TREE ADMIN. Second Review: F]Approved as revised. ElDenied. E]Not applicable PU ORKS Comments: 10 W UBLIC UTILITIES Reviewed by: Date: FIRE SERVICES Third Review: E]Approved as revised. E]Denied. E]Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 r7 MAR 2 9 2018 16TY OF ATLANTIC BEACH L 2 800 Seminole Road 1.) 7 Atlantic Beach,Florida 32233 REVISION REQUEST CORRECTIONS TO PLAN REVIEW COMMENTS Date. 2 Revision to Issued Permit Cbrrections to Commentsz Permit —00 Project Address Sy� &,qvZNW &zw 4/. &AM71,� Contractor/Contact Name— Phone A6.79 73 Email— holvs;,le, 9 !q1PA;1Ca-k Description of Proposed Revision/Corrections: Permit Fee Due$ 1W?AgV41 pma;�C" .&—,,Vq Additional Increase in Building Value $ Additional S.F. By signing below,I �/0/ .A�vdold'of-I affinn the Revision is inclusive of the proposed changes. �N 'W=7 1&4- rinted name) Signature ol-c-or/f�x(Contractor must sign if increase in valuation) da—t e (Office Use Only) Approved Denied Not Applicable to Department Revision/Plan Review Comments Dgortrnent Review Required: Buil in la n- ning &Zoning Reviewed By nis ra or orks Public Utilitie A Public Safety Date Fire Services