343 Plaza DWAY18-0025 driveway permit ?S j11y j.
Cash Register
• • • , Receipt Number
r)
City
of - • •
DESCRIPTION ACCOUNTQTY PAID
PermitTRAK $25.00
DWAY18-0025 Address: 343 PLAZA APN: 170003 0000 $25.00
PUBLIC WORKS PLAN REVIEW $25.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
TOTALPAID BY RECEIPT: . .
11
Date Paid: Thursday,July 19, 2018
Paid By: LOVE NANCY J
Cashier:JDS
Pay Method: CHECK 185
op
Printed:Thursday,July 19,2018 3:39 PM 1 of 1
T"T
CITY OF ATLANTIC BEA(
800 SEMINOLE RO.
ATLANTIC BEACH,FL 32:
INSPECTION PHONE LINE 247-5;
DRIVEWAY- SINGLE OR TWO FAMILY DRIVEWAY
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
'INFORMATION:
PERMIT NO: DWAY1e-0025
Description: replace concrete driveway with pavers
Estimated Value: 5000
Issue Date:
Expiration Date:
RTY ADDRESS:
Address: 343 PLAZA
RE Number: 170003 0000
RTY OWNER:
Name: LOVE NANCY J
Address: 343 PLAZA
ATLANTIC BEACH, FL 32233-5441
AL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name:
Address:
Phone:
R INFORMATION:
Please see attached conditions of approval
[2NING TO OWNER: YOUR FAILURE TO RECORD A NOTICE O
,IMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
'ROVEMENTS TO YOUR PROPERTY. A NOTICE OF
4MENCEMENT MUST BE RECORDED AND POSTED ON THE JI
E BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTA
ANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
1I111F. RECORDING YOUR NOTICE OF COMMENCEMENT.
City of Atlantic Beach APPLICATION N(
Building Department (To be assigned by the Buildi
800 Seminole Road D w A g I $ .
Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845 Date routed:
E-mail: building-dept@wab.us
City web-site: http:1Mmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
�?
5WL) CE wi-A
(dress: JDe artment review re uired
B ,
�� anning&Zoning
� ^ Tree dministrator
\a.l� t��Lf .0 (Ji-lisp, Public o s
Public Utilities
W t"M Ltd 9-{ Public Safety
Fire Services
,epVip Y fee $: Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required of Pemiit Verified B
Florida Dept,of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS ��,(((
apartment First Review: ❑ yo
Approved. ❑Denied. Not a
)ne.) Comments:
ING
3 ZONING Reviewed by: /z, Dah
DMIN. Second Review: ❑Approved as revised. ❑Denied. ❑Not
NORKS Comments:
Building Permit Application dpi
City of Atlantic Beach JU L.
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904124]-5826 Fax:(904)24]-5845
`[� I ...'.�
Permit Number: r.. JWA \A 11
iption G�� L �.7- ,/Jt� I I SD _REp-T
I Work(Replacement Cost)$ b-"i'�Heated/Cooled SF Non-Heated/Cooled_
iss of Work(Circle one): New Addition Alteratio Repair Move Demo Pool Window/Door
e of existing/proposed structure(s)(Circle one): Commercialenval
in existing structure,is a fire sprinkler system installed?(Circle one): Yes No
bruit aTree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
detail th�ty�f cal ork��e pert�o�rmyed:
rCv `GiA-Pl't lA�l 1 r � \!
Juct Approval p for multiple products use product:
honer Informationpy\" L4 ,1
�. Address: 4
Stat eb
Zip Phone
P0'r%t.Lj CIO Q ( ot LYS
Bent(if Agent ower of Attorney or Agency Lett Required)
rinformation ("
ampanY: �^ Qualifyin Age t K�t'10.•ot 'L
6 Fn of Cw City 05 --� State Fi.- Zips
le Job ntact Number
'ication/Registration If ^O 00 O - ail Pav•'-hCti GxaP��r•.•*• •u.-
lame&Phone if I
Name&Phone W
)m
Exempt/Insurer/Lease Employees/Expiation pate
i is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or in.
�d prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws
rn in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBIN
OLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.NOTICE:In addition to the require
ire may be additional restrictions applicable to this property that may be found in the public records of this
be additional permits required from other governmental entities such as water management districts,state
mcies.
4FFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliant
laws regulating construction and zoning.
NG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
'AIN FINANCING. CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
.ed
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ECEIVE '
JUL 18 2018 b CITY OF ATLANTIC ]
BV. 800 Semis
Atlantic Beach,Flori
'.EVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS(
�Rfevision toIssuedPermit Corrections to Comments Permit# D WAI
Iress 3 —l3 , I `p Cl A ' `
/Contact Name /V A IV GC., Wye-
Email
of Proposed Revision/Corrections: Permit Fee Due$
Increase in Building Value$ Additional S.F.
:low,I affirm the Revision is inclusive of the proposed c
(printed name)
'Contractor/Agent(Contractor most sign if increase in valuation) Date
(Office Use Only)
ed Denied Not Applicable to Department
City of Atlantic BeacLJULL
`�I�£— APPLICATION NU
Building Department 2016 (To be assigned by the Buildir
800 Seminole Road Dw�y Atlantic Beach, Florida 322
Phone(904)247-5826 Fax Date routed: �"If 3
E-mail: building-dept@coab.0
City web-site: http:/Awnv.cuab.us
APPLICATION REVIEW AND TRACKING FORM
� 5W o n CaSJ_-t
r
(dress: JLtl � Department review required 1
B
D� anning &Zonln
n Tree Administrator
Public or s
Public Utilities
Public Safety
Fire Services
Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
Sl.Johns River Water Management District
Amny Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
apartment First Review: ❑Approved. Denied. ❑Not ap
one.) Comments:
ING
3iZONING Reviewed by: Date:
DMIN. Second Review: ❑Approved as revised. []Denied. ❑Not at
unovs Comments:
IA:)f)
CITY OF ATLI
le M Department of
1200 Sa
Atlantic Bea
>� (91
PUBLIC WORKS PLAN REVIEW COMMENTS
7/17/18 Applicant: Nancy Love
OWAY18-0025 Email: nancv@coastaladvantac
is: DENIED Site Address: 343 Plaza
THIS PLAN REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS
orrection Items must be submitted to the Building Department at 800 Seminole Roa
Submittals that respond to only one or a few correction items will not be accepted.
ions may not be submitted until ALL departments have completed their respective re,
must be submitted to the Building Department and must respond to EACH departme
DRKS CORRECTION ITEMS: A P P RQV E
✓ocable Encroachment Agreement must be submitted.
DRKS CONDITIONS OF APPROVAL:
ig comments will be printed on your permit as Conditions of Approval)
erosion control measures must be installed and approved prior to beginning any earth
rbing activities. Contact the Inspection Line (247-5814)to request an Erosion and Sed
rol Inspection prior to start of construction.
inoff must remain on-site during construction.
)ff container company must be on City approved list (Advanced Disposal, Realco Recy,
ell's, Inc., Republic Services, Donovan Dumpsters). Container cannot be placed on Cit
of-way.
ight-of-way restoration, including sod, is required.
:rete sidewalk must go through paver driveway.
Scott Williams, Public Works Director swilliams@coab.us/904-247-5834
- REVOCABLE ENCROACHMENT AGREEMENT
,BLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach,Florida,a municipal a
^an�d.ex�istt^iing under the Is f the State of Florida,hereinafter referred to as"CITY"and
M\lam ( 1/`G of Atlantic Beach,Florida,bereinal
)as"US
WITNESSETH:
TrY does hereby grant the USER permission on a revocable basis as described herein the right to e
br the purpose as described in the City of Atlantic Beach. - 0,,(�
is generally described as ?a NP f5 1 Ji A f AR VJ/��t 1 (5ke r�`(�- c
ity maintained, repaired, erected, and/or installed in the exercise of the privilege granted remai
or removal on thirty(30)days' notice by CITY to USER.�sa�id notic to USER,}yh,all be ven by c
eipt requested,to the following address es I bL4 i 6 !.+
the event it is necessary for the CITY or the City's approved representative or other franchised u
ron the above described easement or property of the CITY,the USER shall replace at the USER'$
ry and all material necessarily displaced during the action of maintaining repairing,operating,replac
of the utilities and facilities of the CITY or franchise utility provider.
ie facilities allowed by the permit shall meet the current requirements of the City Code,Building
evelopment Code and all other land use and code requirements of the CITY,including City Code Se
hich states"Driveways that cross sidewalks: City sidewalks may not be replaced with other materi
:replaced with smooth concrete left natural in color so that it matches the existing and adjoining sid
ie USER,prior to making any changes from the approved plans and/or method,must obtain written a
e City of Atlantic Beach Public Works Department,for said change within 30 days after the day of
tis permit shall inure to the benefit of,and be binding upon,the USER and their respective successor;
SER shall meet the terms and conditions of this permit and to all of the applicable State and CITY
ecifications,to include utilities locate requirements and use limitations/requirements of easements,
=ways and other public land. USER further agrees that the CITY and its officers and employees sl
innless by the USER from any of the work herin under the[eons of this permit and that all of said
xe assumed by7ER
Dale
bt�n7erlAgent(si r • en a of Notary Public)
F FLORIDA,CODA Y OF DUVAL
ring instrument was acknowledged this /0 day of S (� 20
4 /1Q (—d V who personally appeared before me in
n n CITY OF ATLANTIC BEACH
OWNER / BUILDER AFFIDAVIT
II 9`T
I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTIOI,
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. THF.SUIT DIN
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 THE 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 CONTRACT-QR 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 FO IRED BY STATE LAW AND BY COUNTY ORMUNICIPAL LICENSING
ORDINANCES
IL INJURY LIABILITY; SINCE OWNERS MAV BE LIABLE FOR IN I RIE 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/OR 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(1). 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.
PHIXJE NUMBER
PRINTMp ME