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309 Magnolia St - Permit DWAY18-0005 \ilj CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 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: DWAY1 8-0005 Description: replace paver driveway &walkways with pervious pavers Estimated Value: 8000 Issue Date: 4/19/2018 Expiration Date: 10/16/2018 PROPERTY ADDRESS: Address: 309 MAGNOLIA ST RE Number: 1704500000 PROPERTY OWNER: Name: ARIEFF SAMULE A Address: 309 MAGNOLIA ST ATLANTIC BEACH, FL 32233-4027 GENERAL CONTRACrOR INFORMATION: Name: Address: Phone: Name: KETTELLINC. Address: 1860 MAYPORT RD ATLANTIC BEACH, FL 32233 Phone: PERMrr 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 - 000s- Atlantic Beach, Florida 32233-5445 OwWK Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us L Daterouted. City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: '8() q �kckq at,�io Department review required Yes No �,uilding Applicant: -_P Fa n n i n g T-23-h—ing-, __F Tree Administra or Project: QC&CCC J_ j3 ajt4 Public W�rk'S---�� Public Utilities D\,k &Q�4 Public Safety Fire Services Review fee $ Dept Sig natAk_11_%���� 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 Engi neers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: VApproved. DDenied. E]Not applicable (Circle one.) Comments: BUILDING J PLANNING &ZONING > Reviewed by:'9 Date TREE ADMIN. Second Review: DApproved as revised. E]Denied. F]Not appiicahlp PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: F]Approved as revised. E]Denied. E]Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 City of Atlantic Beach APPLICATION NUMBER Building Department 'To be assigned by the Building Department.) 800 Seminole Road 000s— Atlantic Beach, Florida 32233-5445 fth i K 9 Phone(904)247-5826 - Fax(904)247-f 1145 I FEB 2 8 2018 Date routed: E-mail: building-dept@coab.us f i Cityweb-site: http://www.coab.us by- APPLICATION REVIEW AND TRACKING FORM Property Address: ab(tq Department review re Yes No ,,J Building Applicant: 14 k �_A(_ <=lanning_&Zon—in-g-,, Tree Administrator Project: �_tDVCCU- 0(kj" &Jt4(,A�l tAi4l&k, Public Works Public Utilities L)\,k Public Safety A,04 S 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: [O/Approved. [:]Denied. ONot applicable (Circle one.) Comments: BUILDING /17 PLANNING &ZONING Reviewed bK J14 Date: TREE ADMIN. Second Review: oApproved as revised. ElDenied. E]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: E]Approved as revised. FIDenied. E]Not applicable Comments: Reviewed by: Date: Revised 05/1912017 E 0 E 0 V E_� Building Permit Application F__ Updated 12 City of Atlantic Beach FEB 2 7 20181 800 Seminole Road,Atlantic Beach,FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 Job Address: 3oq f�424,00// !q �:S� Permit Number: Legal Description 10-16 L4-ZSf-i46 Q46�r c�eL, 3 b�- 306 RE# —10 q�o —(go OC) Valuation of Work(Replacement Cost)$ Heated/Cooled SIF Non-Heated/Cooled zv_� • Class of Work(Circle one): New Addition 63 Repair Move 001 Window/Door • Use of existi ng/p ro posed structure(s)(Circle one): Commercial esidential s • If an existing structure,is a fire sprinkler system installed?(Circle oc�)ne ets NocK_NIA • 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: idt_ Poxzr lei- 101 , Li Florida Product Approval# for multiple products use product approval form PropertV Owner Information N a e: _c�a m -i, -ra kA Address: 3D cl MaJ4 Cit A44.-1�f &4�L� State zip 31133 PhonC' ?-()6 6 S,?4 3 E-Mail_TSk1.1,L h;a ; Q, !401,hby� toy— Owner or Agent(If Agent, PWwer of Attorney or Agency Letter Required) Contractor Information 1]-- 1. Name of Company: �V,el lo/11 0 Qualifying Agent: �AAI 1) cmAohrt- VtwA city A,& State FL, zip Address & - 37-733 Office Phone X1 39L 371& Job Site/Contact Nu ber !Ah YjXeL %tl-3-11-10,09- State Certification/Registration# E-Mailirl�c_ gr ell Architect Name&Phone# Engineer's Name&Phone# Workers Compensation AN 911— 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. 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 RECOT,OURrTI,CE OF COMMENCEMENT. (Signature of Owner or Agent) (Signature of Contractor) (including contractor) Signed and sworn to(or affirmed)before me this C�10 day of Signed and sworn to(or affirmed)before me this"I: 10 day of e ! r '_>9-)I ! 0 STOI —9i I � JENNIFEIR JOHN JENNIFER JO Ow %# TOII&� �Ay CorVMISSIoN#GG 0, EXPiRES;Octob ISSION# 42984 EXPIRES:Oct0ber MYCOMM er 2 C '-'na1u1J­o­fNotary) e of Notary) underwriters P ; I Bonded Thru Nc�-ry Publi d MI.al Bonded Thru Notary ublic eronlly=Kno.n OR [A 114- n K b4,Produced Identification )"Produced Identification Type of Identification: VL a J��,SVk L e Type of Identification: F-1— IL" S C 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 &r" 4- :I;s k4 A!P,* 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 re,P la t,'Q a ddawAm Any facility maintained, repaired, erected,1 and/or fdtalled in the exerefs-24of 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 364 /h"abb"A -5�k44w­ I C, • 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 �V47;� %, USER. Date— Property Owner/Xgent(signed in presence of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL The foregoing instrument was acknowledged this [n day of i Lk k% 120 1 by 7 C15 VIA 4 m 6 x tj Ai L who personally VZALdjefgre me and (printed name of Signer) JENNIFER JOHNSTON acknowledged that he/she signed the instrument voluntarily for the purpose expressed i iV My COMMISSION#GG 042984 EXPIRES:October 27,2020 Bonded Thru Notary Public undenwiters Signa ,j�e Wotary Public,State of Florida Department Approval: Personally Known Produced Identification(Type) FL6_�J#��A'tc AK Sco�WT11i'ams',PubTic Moris_61i7e0tjr Kayle Moore,Public Utilities Director H:\Master Forms\Public-Utilities Works Forms\Revocable Encroachment Agreement 2.5.18.docx Revision Date:2/5/18 RIGHT-OF-WAY/EASEMENT PERMIT Permit#Issued by the City of Atlantic Beach 0 W A "'! I � —00o, PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES Job Address— Phone Perrnitteea, Email_1 0& 0 In(, - co rri Requesting Permission to Construct &k P", - (a1(yW,, Location(Reference to Cross-Street)_ 15?a • 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 1?epartment of Transportation Standards and be performed under the supervision of &�— &4—,*// (Project Superintendent) with Company Name_J�,/Z1 let& — Phone 3 7 7 MOk • 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 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 harinless 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 iately upoyo,5�pletion. Date —,;?o 1 Permjffee-(signed in 1#esenWot`No&y Public) STATE OF FLORIDA,COUNTY OF DUVAL The foregoing instrument was acknowledged this f�k(O dayof Ftbacc,( 20 71 K&V'kcl 9,OL Vv-%0 A C1 V, C W by ,who personally appeared before ine and (printed name of Permittee) acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. Personally Known Signal oTMary POM Produced Identification(Type).F:-L Oi.J-4-i JENNIFER JOHNSTO �Ay co-MISSION#GG 04]2q84 0 0 October 27 2029 EXPI 't.'s Bonded ThN No*,ary Public U TREE & VEGETATION AFFIDAVIT City of Atlantic Beach Department of ommunity Development 9 Z Planning 81 Zoning Division 800 Seminole Road Atlantic Beach,FL 32233 (P)904 247-5800 (F)904 247-5845 PERMIT# SECTION I-APPLICANT INFORMATION /Pl,Owner(s) I— Legal Authorized Agent* NAME OF APPLICANT NAME OF COMPANY ADDRESS OF COMPANY PHONE ZZ,�7 CELL EMAIL 7 7- 7W CONTRACTOR CERTIFICATION NUMBER ATLBCH BUSINESS TAX RECEIPT NUMBER SECTION 11 -SITE INFORMATION STREET ADDRESS OF PROPERTY 3M ON (-q If an address has not been assigned to this propen�6 contact the AB Building Department at(904)247-5826 to request an address. LEGAL DESCRIPTION 16--J5- Zqs n�LI BLOCK C SUBDIVISION LOT _ 506 REAL ESTATE NUMBER /70 LOT OR PARCEL SIZE: SQ FT AC RESIDENTIAL COMMERCIAL OTHER(SPECIFY) offirm that/ have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation"of the Municipal Code of Ordinances for the City of Atlantic Beach, FL andlor/have participated in a pre-application meeting with the Administrator of those regulations. Subsequently, /affirm that no regulated trees and no regulated vegetation will be damaged, destroyed andlor removed from� 1-describe or adjacent properties in conjunction with this project. SIGNATURE OF OWNER SIGNATURE OF OWNER Signed and sworn before me on thisQq.,�Oay of by State of rL— :7K County of 0"t Identification verified: --_ it L J', v S, el =b 0s No HN ON JENNIFER JOH�S��M � A 0 1 # y COMMISSION#GG 042984 EXPIRES.October 276 2020 ters . Thu Notary Pu Ic d _ Notag EXPIRES:October 27,2020 Bonded Thru Notary Public undermiters REV-7VA-v 10.12 My 0 ission expires: