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1460 BEACH AVE - FENCE j ' CITY OF ATLANTIC BEACH 1'1 -')- :!.? 800 SEMINOLE ROAD \ ATLANTIC BEACH, FL 32233 �,;i>� INSPECTION PHONE LINE 247-5814 FENCE WALL OR BARRIER - FENCE MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: FNCE18-0094 Description: 6' FENCE Estimated Value: 5690 Issue Date: 9/24/2018 Expiration Date: 3/23/2019 PROPERTY ADDRESS: Address: 1460 BEACH AVE RE Number: 171863 0000 PROPERTY OWNER: Name: EDSALL RANDY D Address: 1460 BEACH AVE ATLANTIC BEACH, FL 32233-5734 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 1 , Building Department (To be assigned by the Building Department.) 800 Seminole Road -� ,� ��� Atlantic Beach, Florida 32233-5445 I 80044 Phone(904)247-5826 • Fax(904)247-5845 -- E-mail: building-dept@coab.us �`; 2 2018 3 Date routed: g/z4/i S City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: WOO i�GAeH C Department review required Yes No uildinq Applicant: �� � ,Pfarfning &Zoning Th_ Administrator Project: � �C� c o is i i ies .s-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: ['Approved. ['Denied. I of applicable (Circle one.) Comments: _ BUILDING r-3 G -42 PLANNING &ZONING Reviewed by: Date: z7—,e v TREE ADMIN. Second Review: A roved as revise . ❑ pp � 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 E O E UV earlftikif k # 4 Ji42O18D ,-(. t� F »,. ' i3 lorida 32233 ; -, s. p SEP 11 2018 BY. REVISION REQUEST / CORRECTIONS TO PLAN REVIENTS Date gig/I Revision to Issued Permit Corrections to CommentsPermit# FN Ce( 0 — CO9 q Project Address 1 Lite 0 13. ( h /7), Contractor/Contact Name 6YY_t r rl Ft_[ e, Phone ig(e0-grl e//35 Email d 5(./f(ego l cem Description of Proposed Revision/Corrections: Permit Fee Due$ I [, et- 1 A.!i..ALA A air 1 vigr (7 e c hA5hMh4e i1'1 011817 1 G,( `i(,i ii e- Additional Increase in Building--"" Value $ Additional S.F. By signing below,I U/ /f I l/ affirm the Revision is inclusive of the proposed changes. II. digio, name) Signat if tract.'Agent(Contra or must sign if increase in valuation) Date (Office Use Only) 6/ ' 7//0-- , Approved Denied Not Applicable to Department L"'"---------- Revision/Plan /Revision/Plan Review Comments Department Review Required: Bull•in. finning & Zonings Reviewed By -- A d it inistrator Pu. is Utilities Public Safety Date Fire Services s'=v..or, City of Atlantic Beach APPLICATION NUMBER ;3S t/ BuildingDepartment�` ' s,� p (To be assigned by the Building Department.) 4 1 800 Seminole Road o•. r Atlantic Beach, Florida 32233-5445 �— 0_, .12 `0094Phone(904)247-5826 • Fax(904)247-5845 R r � E-mail: building-dept@coab.us Date routed: E /Z�} 1 B City web-site: http://www.coab.us G APPLICATION REVIEW AND TRACKING FORM Property Address: 14 �rI�CAe_t-.1 4v c- Department review required Yes No e<13uildinq) Applicant: Obtj1Dning&Zoning Tree Administrator Project: Co 1 FACE . c o____ is i i ies • 6--Safety Fire Services Review fee $ Dept Signature j 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 'Approved. 7Denied. ❑Not applicable (Circle one.) Comments: " BUILDING In 41)'t yGCl PLANNING &ZONING by:.__ __ Date: 82� I S Reviewed b TREE ADMIN. Second Review: roved as revised. pp I Denied. ❑Not applicable PUBLIC WORKS Comments: . PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: / Date: C) -7~ 13 FIRE SERVICES Third Review: ❑Approved as revised. I (Denied. nNot applicable Comments: Reviewed by: Date: Revised 05/19/2017 ____,.. ____, r______ E © rclCI' --, , ,,.,s,,,,, ,,,,,_ CITY OF ATLANTIC BEACH r imy) 1 SEP 4 2018 1 800 Seminole Road T.) � i Atlantic Beach,Florida 32233 REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS Date gig/is Revision to Issued Permit Corrections to CommentsPermit# r,o Cir' 0 — CO9 c Project Address 1 Lk, 0 13 ectch /u-L Contractor/Contact Name 5m,t f t Foil e, Phone gQd-elle-if 35 Email Ced5c1`(p oo/t cowl Description of Proposed Revision/Corrections: Permit Fee Due$ 4i-'1u4 p/ of i n(t vtwq (mawP ciiii htoktiijit4e4 (UYl (fit r/1 G,( i(.l lv e Additional Increase in Building" Valuee!$ Additional S.F. By signing below,I [i/L_ -#i► Ccy . //f affirm the Revision is inclusive of the proposed changes. __ iiivname) Signat 'f rt.'"gent(Cont . or must sign if increase in valuation) Date (Office Use Only) Approved / Denied Not Applicable to Department Revision/Plan Review Comments Department Review Required: Bu'ildin ( -- . ----- arming &Zoning Reviewed By -- £dninistrator 11111 �;_ — P-- /S P_u. is Utilities _ Public Safety Date Fire Services COMMUNITY DEVELOPMENT APPROVED LOT 10 BLOCK 60 _.'` :Si \ LOT 13 SET 1/2' I`. BLOCK 60 LOT 12 LOT 11 IRON ROD II BLOCK 60 BLOCK 60 LB #7893 r"< 1. -I SETIRO1/2" OD I° 142.0' _r 0.1' 67'25'24"(P) 20.0' ' LB 17893 0.3' .::.. . LIJ w 91'17'20"(P) f iN2 9:014�I �I• �: NC 30.1' ..�• :• .: _ I_-�'W'0_ ►0A pOOL .A^ RESIDENCE S t o ` < I�� ,,r N ORIyE o #1460 LOT 0p`1rOftt•.��I1 /ar LOT9 BLOCK 60 0o a �,, WoI.I_���u+;j�� BLOCK 60 In • to N ♦i►I��41,i. 623 6 �:*,� f..:_..,_m ,____ j °0 .II_I'�.�•••�rL�tlHLI_I_ !4:20.9' 20-0' .�i��tv :.. .. o In Ic �I4 yi4y�. a0. -0.47. 0.4• 92'34'36"(P) .. 140.0' SET 1/2" a '` 1_t' IRON ROD `� _ SET 1/2" LOT 6 LB Iy7B93 0 Y .. LOT 7 IRON RODLB BLOCK 60 FOUND 1/2" BLOCK 60 X893 IRON PIPE a 41 a 0 FOUND 1/2" IRON PIPE o ® BLOCK CORNER SURVEY NOTES CONCRETE DRIVE CROSSES THE PROPERTY LINE ON THE EASTERLY SIDE OF THE LOT. THERE ARE FENCES NEAR THE BOUNDARY OF THE PROPERTY. • • PAGE 2 OF 2 PAGES E O N,N BOUNDARY SURVEY LB#7893 1 T I T i f v�G,� 5 T9C No.?B83 0",..„b, TJ4RGET 1. SURVEYORS CERTIFICATEa IHEREBYCERTIFYTHATTHISBOUNDARYSURVEY �� SURVEYING, LLC Q IS A TRUE AND CORRECT REPRESENTATION OFA m i SURVEY PREPARED UNDER MY DIRECTION. '' ,, STATE OF NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC °r L 0 R I O P p9„ SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL, SERVING ALL FLORIDA COUNTIES L s u g v C 4 OR A RAISED EMBOSSED SEAL AND SIGNATURE 04,"sv.m bcrpe 0. 6250 N.MILITARY TRAIL,SUITE 102 Clyde O. "MW ON w=Clyde o.raweai,c WEST PALM BEACH,FL 33407 t� =uSo=ra.s :y. PHONE (561)640800 ✓��J 500. McNeal W�'a„�'� (SIGNED) 02°'5'2",a ose- FACSIMILE (561)640-0576 STATEWIDE PHONE (800)226-4807 CLYDE D.MCNEAL,PROFESSIONAL SURVEYOR AND MAPPER#2883 STATEWIDE FACSIMILE (800)741-0576 ot.i-vp;yt, City of Atlantic Beach APPLICATION NUMBER `�� t„ Building Department (To be assigned by the Building Department.) ii l 800 Seminole Road -- w / Atlantic Beach, Florida 32233-5445 E 0_, .15 0044 Phone(904)247-5826 • Fax(904)247-5845 SJR yr E-mail: building-dept@coab.us Date routed: '/Z4/i B City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 147o 6 G Re" AV'C- Department review required Yes o uilding j r� Applicant: 0(AD Hing &ZoningTh l Tree Administrator Project: cc, I _ 3 c o blic Utilities -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: proved. Denied. ❑Not applicable (Circle one.) Comments: UILDING PLANNING &ZONING Reviewed by: Date: -a-p-i TREE ADMIN. Second Review: PKoProved as revised. ❑Denied. ['Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date:9'‘20-/ O FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 E 01 11V E, ffm CITY OF ATLANTIC BEACH RI SEP 4 2018 800 Seminole Road Atlantic Beach,Florida 32233 \A. } REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS Date _!l 14' p Revision to Issued Permit Corrections to Comments 1 Permit# FN CE( S-— CO9 cl Project Address I qte U 13ga t 1 , v-e__ Contractor/Contact Name SrYI.I r r l Fol.( e. Phone C/,C)-'7/e'/f 35 Email ici5a 1(@ Q01 cowl Description of Proposed Revision/Corrections: Permit Fee Due i. ii,t5K1j-G6tet9( &A 0)1)81710 (,rive-V Additional Increase in Building Value $ Additional S.F. By signing below,I Ci/ 1 E-d l7 affirm the Revision is inclusive of the proposed changes. -.. o' name) Signat . of • ract.'gent(Cont . or must sign if increase in valuation) Date (Office Use Only) Approved K.....----- Denied Not Applicable to Department Revision/Plan Review Comments (t.)/7 1,:, ,,/--- JO V_ /Z k- ✓ p 3. 6 CO rt. Department Review Required: Buildinfilfr anning &Zoning v Reviewed By -- Administrator 11110:-7Works p� Pu. is Utilities Ci'd 0-0 Ul d Public Safety Date Fire Services `r-AiBuilding 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 Q n Job Address: /41&O 66-40/ '1 ArmMc &4(i-1 32233 Permit Number: I-N e.0 If'7` 00°4 Legal Description P6 QCF R&Pt4Ct44tA/T RE# Valuation of Work(Replacement Cost)$ 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: L do a = 4z �. Florida Product Approval# for multiple products use product apEeos fz U0 t— Property Owner Information O w O 3 ti.i Name: Lc t/ 6'1)&14-4- Address: 191,0 ee4y ALS cap a EI City 4NT/C. LEA-C-i-1 State F— Zip 3 & 723 y Phone c--g/�-//3,5 U 11:U a U 0 E-Mail eed aallCaadl• (rYfl CI Z CC Z Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) 0 Q 2 < c--. Contractor Information FJ 0 N CCQ1- z Name of Company: 1111 n-1 FE.0(F j,p/uP,4 J1J S,NL Qualifying Agent: 0 LL s LU Address /32/ 41A-RtitUC( 5T City DA-cKSo,vvr c-LE State 6- Zip 3L /0ril W Office Phone 0:0)1) 7 --�3 -7/ 75 Job Site/Contact Number W }. O. CC CO State Certification/R�gistration# E-Mail 6'1))i f h •�(i ice Co @ ,afioo , ee ► 3 W Architect Name&Phone# W V~ W Cl) W ?� Engineer's Name&Phone# 5 a w Workers Compensation CC CC 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 RECO NG YOUR NOTICE OF COMMENCEMENT. ,,f.2k_ a/b (Signature of Owner or Agent) (Signature of Contracto (including contractor) ed and sworn to(or affirmed before me this day o Signed and sworn to(or affirmed) • ore me this day of ,Z0( 8, by VV lee i• Sa , by MIIWM . (Signature0 Notary) I • _>°` Y,PY"k„ TO'••i ,-,. - -: t re MY Ca MISSIONOf*g tdre Notary) ,4g EX'IRES:October 6,2019 [ ]Personally Known OR [ ]Pe Orta(K;7eT1ovBPPORThruNotary Public Underwrters [ ]Produced Identification 2c� / . [ ]Pr... -. 6' . o Type of Identification: JZ- A �(7- ) 1-CO/ Type of Identification: Fer,r?v7L -tP- f/1JLEl P- oc'q NOTICE OF COMMENCEMENT State of FLOR/Q-4 ( }r- HCL Tax Folio No. 1 —7 t a(03 — 0000 County of 7UVA-L To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. ii Legal Description of property being improved: I C, —l. l l (A-- Z S- Z.9 - �a n.d°A 4.14 Lai 1j1k (cp O Address of property being improved: /96,0 /36A-C-14 MIE ,4T1AAir/C 66.-4c,ii FC, 3 Z 3 3 General description of improvements: kbPL-4C-E--- (p lam/ PEA) C Owner: 6 L e&-1) Eba4-Lt. Address: /5/FaD 464-et+ ,4414---E A.6; ft_ 32.2-3 Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: Contractor: 5 f4 I T}I FE/l)C 6 CD Address: 13aq MAR ci-t-&-C 6T- Telephone 9T1/4..t\v‘ Telephone No.: C.!bel) 7513 -?(7 5 Fax No: Surety(if any) Address: Amount of Bond$ Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: Address: Phone No: Fax No: Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be served: Name: Address: Telephone No: Fax No: In addition to himself, owner designates the following person to receive.a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNE D Signed: 0€ 41,D Date: 6/..2q/./3 l,1 Before me this 7_4- day of A, Z of $in the County of Duval,State Doc#2018201279,OR BK 18504 Page 2465, Of Florida,has personally appeared l,# Number Pages:1 Votary Public at Large,State of Florida,Coun,\ + Duv. Recorded 08/24/2018 02:37 PM, Vty commission expires: RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Personally Known: I �— _ or COUNTY Produced Iden' • �,. , �� IP RECORDING $10.00 _;Q 'P"'•., TONT GINJLESPERGER '� '` M"COMMISSION#FF 924951 •z ` EXPIRES:October 6,2019 L 'F!;,00 Gentled Mrs Notary Public Underwriters ' ;,, CITY OF ATLANTIC BEACH �`7.5 "r IJ%WNER / BUILDER AFFIDAVIT ..r;;9%' I. 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 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 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. II. 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/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. Mg ,8e/-C 4 /SIE — C1/M- P3 s ADDRESS PHONE NUMBER ---LP0 L-n) Ei)5 1---1 - PRI, R, E At A-.JAI" g9kictiil epcif le SIGNATURE 7// DATE Before me this ZT day of ,20/6,the county of Duval,State of Florida,has personally appe+Q )herin by himself/herself and affirms that all statements and declarations are true and accurate. Notary Public at Large,State of P( ,County of Q ❑Personally Known ('-'�Z4 _ - ,-. . ❑Produced Ident cato (1 ( -'7 • Notary Signature. !ant ` Y P YTCOONM!GMIISDILOENSPtEFRFG9E2R49 51�P M,. EXPIRES:October 6,2019 •yoF°•' Bonded Thru Notary Pubhc Underwriters /. F:/BLDG/Owner-Builder Affadavit;REVISED: 4/16/2009 (p-vpri, City of Atlantic Beach APPLICATION NUMBER f ;• .), Building Department .+ _7 (To be assigned by the Building Department.) � A 1• 800 Seminole Road Atlantic Beach, Florida 32233-5445 8 0094 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us AUG al Date routed: g/zq-/l S City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 4 ReA l v C— Department review required Yes No uildinq Applicant: KDe- nmg &Zoning Tree AdministraTor Project: 6 rDCE is o • is i i i ies i. .c-Saf_ety 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: t Approved. ❑Denied. I 'Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed b Date: r���/� TREE ADMIN. Second Review: roved as revised. I (App I (Denied. I Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. riNot applicable Comments: Reviewed by: Date: Revised 05/19/2017 C� l V= j r _ , 0 1....A.,,tr,,, r r • inANTIC BEACH SEP 4 2018 ' n/ •�., ,ole Road �t« r' 111- Atlaantic'each, ~ja32233 � 0111, ' 1 j' 2018 REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS Date `t l ill I Revision to Issued Permit Corrections to Comments kPermit# FN ce( 0 — cx)91� Project Address 1 tfi 0 L3ecLCT /47..)-e„ Contractor/Contact Name 5M I t i l Fell_( (J. Phone gw-?f e-//•3 5 Email 6;d56-11(L.=a0l a5)41,_ Description of Proposed Revision/Corrections: Permit Fee Due$ I t. et, I 1 '!�IL't A it'I _' "A r<J I /�' 'M- J oK it h rte, Ana;[ iti1e Additional Increase in Building Value$ Additional S.F. i "" By signing below,I � z ?xz fi affirm the Revision is inclusive of the proposed changes. Aiiiiv name) Signat df ue racts'gent(Contra or must sign if increase in valuation) Date (Office Use Only) Approved ✓ Denied Not Applicable to Department Revision/Plan Review Comments c Department Review Required: . Building ///V' anning & Zoning } �'�� "�e lir •-y tr.- -- Ad inistrator .4111 :M-. 1111111, Pus is tilities f.— 1,47Public Safety Date Fire Services LOT 10 I BLOCK 60 ;Si LOT 13 LOT 11 SET 1/2' BLOCK 60 LOT 12 BLOCK 60 IRO NR93 BLOCK 60 1 : _e, SET 1/2' N Q, r I 01 87'25.24'(F') 20.0• IRON ROD cD 142 _ LB #7893 0-3 _ W-o 91'1T20'(P) —� -� 'III i_..II��'�i►��2Jx4��...+ :. VP*• i0r .rte ��//t' ir�t�� 'Z o = `••LIII- .-v,, 21 0 '' o Aic 3°.3 ----; . - o' ��� POOL .II•6 1 a ,I.:71"..":.:.•....-.- 4ORETE o`F: < c Vii SII^ t4z RESIDENCE Dl c3--i..'..- ,. # "Sir '� p #1460 `: L° U LOT 8 17--�� i�I�//Ja11 LOT 9 BLOCK 60 IL IIt44= ,,',:. Q "..t'I_f�'I_I r,*, - tz BLOCK 60 W o 4�f 823• TFS. AT. ILII+.- +�I.I IILLI_� �7 20.9• 20.0' �.•I1 40.4 m •�itl`It _ 92•34'36'(P) taw.,�.i : IA' 140.0 SET 1/2" 45 0_ i':--_:. IRON ROD `� LB #78930 ''. ET 1/2"ROD LOT 6 ?; I:':. -,, LOT 7 #7893LB BLOCK 60 FOUND 1/2' i' BLOCK 60 IRON PIPE ki a 0 F UND 1/2' 0, 1 0 RON PIPE o 0BLOCK CORNER • SURVEY NOTES 1c) CONCRETE DRIVE CROSSES THE PROPERTY \\\ LINE ON THE EASTERLY SIDE OF THE LOT. THERE ARE FENCES NEAR THE BOUNDARY '\ OF THE PROPERTY. 2P PAGE 2 OF 2 PAGES ' A', 1°F-OE MI `N BOUNDARY SURVEY LB#7893 Cq)-q c. NO.2683 f O_\ Tl4 ! RTA SURVEYORS CERTIFICATE ° . I HEREBY CERTIFY THAT THIS BOUNDARY SURVEY SURVEYING, � � P IS A TRUE AND CORRECT REPRESENTATION OF A '''''' ,„_,.......1 •f .t SURVEY PREPARED UNDER MY DIRECTION- 'c4�- SAT o a STATE 0 SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL, SERVING ALL FLORIDA COUNTIES 44 S U R v C' ORA RAISED EMBOSSED SEAL AND SIGNATURE. br Cbde°. 6250 N.MILITARY TRAIL,SUITE 102 Clyde O. ''=ClydeoWNW,c WEST PALM BEACH,FL 33407 =USa .W.0 a PHONE (561)6404800 (SIGNED) 14":"'"''''''..."-f::;7°McNeal �2015.12_1713.3IL5- FACSIMILE (561)640-0576 STATEWIDE PHONE (800)226-4807 CLYDE O.McREAL,PROFESSIONAL SURVEYOR AND MAPPER#2883 STATEWIDE FACSIMILE (800)741-0576 1