664 Beach Ave DWAY18-0026 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 NEICT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: DWAY1&-0026
Description: Replacing Concrete Driveway with Pavers
Estimated Value: 12200
Issue Date: 8/16/2018
Expiration Date; 2/12/2019
PROPERTY ADDRESS:
Address: 664 BEACH AVE
RE Number: 1701280000
PROPERTYOWNER:
Name: MELANCON DEJEAN JR
Address: 664 BEACH AVE
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Comprehensive Home Services, LLC
Address: 4980 Devils Den Road
Keystone Heights, FL 32656
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 requirernents of this permit, dim 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.
Permit Conditions
12 City of Atlantic Beach
Permit Number: DWAY18-0026 Description:Replacing Concrete Driveway with Pavers
Applied:8/14/2028 Approved:8/15/2018 Site Address:664 BEACH AVE
Issued:8/16/2018 Finaled: City,State Zip Code:Atlantic Beach,FI 32233
Status:ISSUED Applicant:<NONE>
Parent Permit: Owner:MELANCON DEJEAN III
Parent Project: Contractor:<111I
Details:
LIST OF CONDITIONS
SEQNOJ ADDEDDATE REQUIREDDATE1 SATISFYDATE TYPE STATUS
DEPARTMENT CONTACT REMARKS
1 1 8/15/2018 EROSION CONTROL INSTALLATION INFORMAL IONAL
PUBLIC WORKS Scott Williams
Notes:
Full enosion contral measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line 1247-
5814)to request an Erosion and Sediment Control Inspection prior to start of construction.
2 1 9/15/2018 1 7___0N SITE RUNOFF INFORMATIONAL
PUBLICWORKS Scott Williams
Notes:
All runoff must remain on-site during construction,
3 1 8/15/2018 1 ROLL OFF CONTAINER INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Roll off container Company must be on City approved list JAdvanced Disposal,Realm Recycling,Shapell"s,Inc.,Republic Services,Donovan
Dumpsters). Container cannot be placed on City right-of-my.
4 8/15/2018 _FR GOT OF WAY RESTORATION INFORMATIONAL
PUBLIC WORKS Sc.tt Williams
Notes:
Full right-of-way restoration,including sod,is required.
5 1 8/1 _2018 1 1 RUNOFF INFORMATIONAL
PUBLICWORKS Scott William,
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
101,
Printed:Thursday,16 August,2018 1 of 2 1-
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach,Florida 32233-5446
Phone(904)247-5826- Fax(904)247-5845
E-mail: building-dept@coalb.us Date muted: Ilk
City web-site: http:/Avww.coab.us I - —
APPLICATION REVIEW AND TRACKING FORM
Property Address: (eb� pwe' Department review required Yes No
Build ng
SVC
Applicant: C0fXDr_1eh9MS1ye� J('Plannino&ZonlZ
Project: gemb�& 1,<TJj2Ce !�J Tree Administrator
Public Utilities
PA-W3 Public Safety
Fire Services
Review fee $
Rev'ew
Other Agency Review or Pemnit Required Of Pemu,=%, Date
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Any Corps at Engineers
Division of Hotels and Restaurants
DiAsion of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: pproved. ODenied. []Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:.'10�� Date
TREEADMIN. Second Review: OApproved as revised. ElDenied. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date
FIRE SERVICES Third Review: EJApproved as revised. DIDenied. E]Not applicable
Comments:
Reviewed by: Date:—
Revised 05119/2017
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department
800 Seminole Road
Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-deptil Date routed:
City web-site: http:1/www.Wab.us ki
Rylt
APPLICATION REVIEW AND TRACKING FORM
Property Address: Wpi`V Ave- Department review required Yes No
EVC B�
Jill d"
lannlnq�
Applicant: CbMplrghelislye, &Zonln
me�onmmsmator
IV-ublic Works
Project: Rcmov� Public Utilities
Public Safety
Fire Services
Review fee $
Review
Other Agency Review or Permit Required of Pemi Date
Florida Dept.of Envisnartmental Protection
Florida Dept.of Transportation
--itJohns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: VApproved. [-]Denied. E]Notapplicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed bar Date:
TREE ADMIN. Second Review: E]Approved as revised. ODenied. ONotapplicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. DiDenied. E]Not applicable
Comments:
Reviewed by: Date*-
Revised OW1912017
Building Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FIL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: Permit NumberbWeL
Legal Destriptior��w&A %\Pr4il -%.t? 0- —RE#_
Valuation of Work(Replacement Cost)$ IVI'llib Heated/Cooled SF_Non.Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Windo./Door
��o —
• Use of existing/proposed structure(s)(Circle one): Commera.al \Residential
• If an existing structure,is a fire sprinkler system Installed?(Circle one�yes No LNaA
• Sulinnit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
7�the type of work I to be performec1:,J,...,T- 7"��
Florida Product Approval If NIA for multiple products use product approval form
Prooertv Owner Information I
N �!*- 4.LA4L,&- Address,
C17 tate%Vk Zip Phone N0.1
EMail�-`, AM�43"14L- l\W &-3tW—,!S - G�Pfli
Owner or Agent(If hgent,Power of Attorney or Agency Letter Required) NAIAIJ
Contractor Inform t on
Name of \"G- 'S6ILWic1*- Qualifying Agent:jLV&L4&i
Address PA, city t -Zip''I"1-6'r
Offil,�Phone Job Site/Co OL
State Certification/Registration 121scillf-1. E-mail W-SACAmid A60 C 4611
Architect Name&Phone If
Engin"i's Name&Phone i
Workers Compensation
Exempt/Insurer I LeasetEandmeas I 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 lam 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 cou n ty,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
LT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTE ID
1,9 ]BTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
--D G 0
R IN Y UR NOTICE OF COMMENCEMENT.
TOP
tr (Signature of Owner or Agent) (Signature 'Z
Zi U (including contractor)
co
Ed and sworn to(or affirmed)before me this day of �igned and sworn to(or affirmed)before me this��da
0.
by
by�, at�n by
Signature of Notary) Notary)
LiZ..e..61,ifersonally Knmem OR I ]Personally Known OR
AOFProduced Identification JYf5roduced Identification
Type of ldentification! i�\- �'�.q. 'cc Type of Identification: R\. 2 c,*
REVOCABLE ENCROACHMENT AGREEMENT
REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach,Florida,a municipal corporation
-gv,anizqd and exi=r the laws of the State of Florida,hereinafter referred to as"CITY"and
-��4 of Atlantic Beach,Florida,hereinafter
referred to as"USER".
WITNESSETH:
That die CITY does hereby grant the USER permission on a reveamble 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--Z�CftAq6rL--w4lL
Any facility maintained, repaired, erected, andlor 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,
retain receipt requested,to die following address
• In the event it is necsessary for the CITY or the City's approved representative or other franchised utility to enter
upon the above described casemsm 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 maintainin&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 landiuse and code requirements of the CITY,including City Code Section 19-7(h)
which states"Driveways that cross sidewalks: City sidewalks my 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 my chainges from the approved plans and/or method,most obtain written approval from
the City of Atlantic,Beach Public Works Depar-ftnent,for said change wi thin 30 days after the day of completion.
• This permit shall
inme to die 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 locale requirements and we limitations/requirennents of egisements,public right-
of-ways and other public land. USER further agrees that the CITY end its officers and employees shall be saved
harmless by the USER from my of the work herein under the terms of this pernin and that all of said liabilities are
hereby assumed by the USE&
4uzo-�— Dat
Prophe�OwVgent(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL -et
The foregoing instrument was acknowledged this__X��day of XQQI� 20 \
by r Ce-\ who personally appeared before me and
;��.n �,of Signer)
acknowledged aent volumarily se in it.
c=ngwm*GGIa755I
Eon,,JkJy 16,2022
0 .:
�,�,f Notary Public,State of Florida
Department Approval:
Personally Known
Produced Identification(Type)�y\
Scott Wilrialks,linblicv,07ki 15 0�
irector
Kaylc Moore,Public Utilities Director
H.Waster Forms\Pubhc�Uflflties Works FOrms\R�axable Encroachment Agreement 2.5.18.docx
ReVision Date:2/5/18
RIGHT-OF-WAY/EASEMENT PERAHT
Permit#Issued by the City of Atlantic Beach
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND ORTAE41NG UTILITY LOCATES
Job Address VA awrA, k14— Phone
Pennift, Email ��tkzW JJIA&LfWk-Laq
Requesting Permission to Construct —1�cxsift
Location(Refierence to Cmss-Stmt)-I#4 -&*A k,� —tww1w L;"r' 4 -T"
• 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 m relocation of all,or my portion of mid street or easement as determined by the Director of Public
Works, my or all said poles,wires,pipes,cables or other facilities and appurtenances authorized hereunder,shall
be immediately removed firain said street or camment or rcset or relocated hereon as required by the Director of
Public Works and at the expense of the Pennittee unless reimbursement is authorized.
• All work shall meet City of Atlantic Beach okF_Iorida Department of Transportation Standards and be performed
under the supervision of (Project Superintendent)
z4�k k e—C)
with Company Nam���-49�,OF4:�F�U-- Phonejb4�6'(A
• 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 ali practical,in keeping with City specifications
and the roamer 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 sliming any increase in impervious area on owner's lot or in the City
right-of-way are to be included with this application.
• The pennittee shall commuce actual construction in good faith within_days. If the beginning date is more
than 60 days from date of permit approval then perinittee must review the permit with the Director of Public
Works to make am no changes have occurred in the men,that would affect the permitted construction.
• It is understood and agreed that the fights and privileges herein set out we granted only to the extent of the City's
right,title and interest in the land to be entered upon and wed by the holder,and the holder will,at all times,
assume all risk of and indemnify,defend and save harridess the City of Atlantic Beach from and against my and
all loss,damage and cost of expenses ansing in my manner of the exercise or attempted exorcises by the holder of
the aforesaid fights and privileges.
• The D rector o Pu mks shall be notified twenty-four(24)hours prior to starting work and again
i is upon omple n.
06
Purnmee(signed in presence of Notary Pliblic)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this�\\-\ day of 20
by whopersonally appearedbeforeme and
(printed mine of Penuittee)
acknowledged at shes no the instrument volurnarily for the purpose expressed in it.
4 —2 Personally Known
g�.m.—.f Notary P-01c,State of P Torida Produced Identification�Crype)i��' �, 19
ALYSUStryll
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TREE &VEGETATION AFFIDAVIT FOR INTERNAL OFFICE USE ONLY
City of Atlantic Beach PERMIT#_
Community Development Department
800SendnoIeRoad Atlantic Beach,FL 32233
(P)904-247-5800
SITE INFORMATION
ADDRESS
SUBDIVISION BLOCK LOT
RE# RESIDENTIAL E] COMMERCIAL OTHER
APPLICANT INFORMATION
NAME"-k�j�� PHONE# 0l0q- 601--L615
ADDRE55 —t>�� CELL#
CITY —b4.J�, STATE S;A ZIP CODE
EMAIL7::��*6-\65- JJLP �9OWNER LEGAL AUTHORIZED AGENT
I affirm that I 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 Florida and/or I have participated in a pre-
application meeting with the Administrator of those regulations. Subsequently,I affirm that no regulated
trees and no regulated vegetation will be damaged,destroyed and/or removed from the above-described
property and/or adjacent properties including right-of-way.
IN 7EBYCERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT:Signature ofPropeny Owner(s)or Authorized Agent
�v- &�� —Jl� Z�--�50 — 1 -,7-4 — 'd1141tk
IICNATr)OF APPLICANT PRINT OR TYPE NAME DATE
SIGNATURE OF APPLICANT(2) PRINTORTYPENAME DATE
Signed and sworn before me on this day of by State of
County ofs��111'112�
Identification verlfied:'��
oath Swom: E] Yes
,,,,A=LS:,ER
=7GG��--$Sl e�,t, Sgnature
Exom My 16,20,
Exom My 16,20,
ok", MyCornmisslon expirel�z�,��. C��,
04 TREE AVIT03.0?.2018
AW-15-2010 09:24 FRDtl:RF)NDY W RUDD 3525464744 TO:19042475845 PA
RA-8-2818 12:33 FFMRANDY W RUDD 3585464744 MilgB43671757 P.1
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RecmWIM1401001:54PM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00
PDENA R�A�Y
2018