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345 BELVEDERE ST - FENCE FENCE WALL OR BARRIER PERMIT PERMIT NUMBER � .. > CITY OF ATLANTIC BEACH FNCE18-0124 Irl 800 SEMINOLE ROAD ISSUED: 11/29/2018 EXPIRES: S28/2019 ��, � ATLANTIC BEACH. FL 32233 / MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY. 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. JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: 345 BELVEDERE ST FENCE WALL OR BARRIER FENCE 6' FENCE $1000.00 TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170703 0268 SEASPRAY COMPANY: ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ZIP: COLEMAN DONALD R 438 INLAND WAY ATLANTIC BEACH FL 32233-4682 WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR 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. LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 1 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. 2 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL Notes: Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapells,Inc.,Republic Services,Donovan Dumpsters, Phillips Containers). Container cannot be placed on City right-of-way. 3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. Issued Date: 11/29/2018 1 of 2 `' 'CJJii, - FENCE WALL OR BARRIER PERMIT fPERMIT NUMBER CITY OF ATLANTIC BEACH FNCE18-0124 �,% 800 SEMINOLE ROAD ISSUED: 11/29/2018 '--.1. " ATLANTIC BEACH. FL 32233 EXPIRES: 5/28/2019 4 PUBLIC WORKS FENCING REMOVED INFORMATIONAL Notes: All old fencing must be removed from job site by Contractor. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PLAN CHECK 455-0000-322-1001 0 $17.50 FENCE 455-0000-322-1000 0 $35.00 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$81.50 Issued Date: 11/29/2018 2 of 2 City of Atlantic Beach APPLICATION NUMBER etAn-,,,, Building Department (To be assigned by the Building Department.) )`i 800 Seminole Road / /� f _ �0 Atlantic Beach, Florida 32233-5445 h 1\)'�IS—0IZ T Phone(904)247-5826 Fax(904)247-5845 I / it �,; y Email: building dept@coab.usDate routed: ( / ( („ �_ City web-site: http://www.coab.us ttt APPLICATION REVIEW AND TRACKING FORM PropertyAddress: 3 4 E C.VEC D rtment review required Ye No Buildings Applicant: OW f\D--e inning &Zoninq� 1_ Tree Administrator (.../3i Project: ( — .KDC_:. is Work is Utilities Public 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: (BUILDING) PLANNING &ZONING Reviewed by: / ,i9-- Date: /' 90 '/61- TREE ADMIN. Second Review: ['Approved as revised. ❑Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. I 'Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 , tAit, City of Atlantic Beach ECEIVE� APPLICATION NUMBER Js �� Building Department (To be assigned by the Building Department.) 800 Seminole Road NOV 1 6 2018 t- (\, r? Atlantic Beach, Florida 32233-544 V C-G,IS-01Z4Phone(904)247-5826 • Fax(904) -5845 _r' �� E-mail: building-dept@coab.us — Date routed: Ali ( (-n it City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3 4 `-3 E-VE Department review required Yes No (Buildinyg_ Applicant: r)CAD I�C.----, anning &Zoninq 1` Tree Administrator Project: (L- 1—�:kpeti 1iic Work is Utilities j Public 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. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by Date: ll—/f# TREE ADMIN. Second Review: ❑Approved as revised. ❑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 City of Atlantic Beach APPLICATION NUMBER " jr00 Building Department (To be assigned by the Building Department.) 41:4\•-, 00 SeminolecRoad N C� i �j /- lz 9-\.,..!.9 �.,. •-r Atlantic Beach, Florida 32233-5445 V l-. C"�—�1 y� Phone(904)247-5826 • Fax(904)247-5845 p -o; y� y E-mail: building-dept@coab.us Date routed: I ( / ( (n r 1 ) City web-site: http://www.coab.us 111 APPLICATION REVIEW AND TRACKING FORM Property Address: 3 4 S Department review required Yes No ( uiIding) Applicant: e _. anning &Zonin_q� Tree Administrator Project: (P 4Pcrt5Tic Worms is Utilities Public 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: 7rApproved. ❑Denied. ['Not applicable (Circle one.) Comments: BUILDING � PLANNING &ZONING Reviewed by:r-- Date:0-1- TREE ADMIN. Second Review: ❑Approved as revised. ❑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 t::1.`1 j%, City of Atlantic Beach APPLICATION NUMBER �s ! Building Department NOV (To be assigned by the Building Department.) E r A s 800 Seminole Road /�1 6 20 8 �\, /� r Atlantic Beach, Florida 32233-5445 F (V Ce,I S_0124 1 Phone(904)247-5826 • Fax(904)24$ / / E-mail: building-dept@coab.us --- Date routed: I ( / ( (s0 / ( CS City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3 4 S ELVEQC-EC- Department review required Yes No �Building_.) Applicant: OW N` --e > arming &Zoning Tree Administrator Project: G", �i�J is Work is Utilities Public 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. Not applicable (Circle one.) Comments: `g—� BUILDING PLANNING & acco Ot • Reviewed by: �`� Date: I/—f�1—, / TREE ADMIN. Second Review: Approved as revised. ❑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 fin\ Y- REVOCABLE ENCROACHMENT AGREEMENT REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida,a municipal corporation or ized and existin under the laws o the State of Florida,hereinafter referred to as"CITY"and �� Lvt4 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 te-si tfif . 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 noti to USER h I1 be given by certified mail, return receipt requested,to the following address 7 fie* 0,e r. • 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 reume• • the US�,� l 4'W /U'_ Date I ( '/h ' /Q Property Owner/Agent(signed in presenc4Lf Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL / / The foregoing instrument was acknowledged this ! 6-, day of 1Q©v 20 l 6 , by I� e-0 k 11A a4e1J`2 ,who personally appeared before me and (printed n. e ,f Signer) ack ledged .he signed the nstrument voluntarily for the purpose expressed in it. c ' Signature of Notary Public,State of Florida Department Approval: Personally Known Produced Identification(Type) . L. / v Scott WI hams, Public orks Director f >r;'F;x. iONIGIND�ESPERCER ""` ' • ISSION#FF 924951 , O:\Public Works\ADMIN\Revocable Encroachment Agreement.docx October 6,2019 Revision Date:8/31/18 :..,..,c;3ry Public Underwriters r5'y11ir Building Permit Application Updated 10/9/18 City of Atlantic Beach Building Department **ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY -46119r Phone: (904)247-5826 Fax: (904) 247-5845 Email: Building-Dept@coab.us IS REQUIRED. Job Address: 31-1 c Q\V ii'- cT C Permit Number: PENC& t `v( 21 ! Legal Description It•eYyt pie siAdavplace Yom[--C RE# I-7 0703 - OZ G g Valuation of Work(Replacement Cost)$ `0UL?' Heated/Cooled SF A.72 Non-Heated/Cooled NY4 • Class of Work: ❑New ❑Addition ❑Alteration [1Repair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial e'<sidential • If an existing structure, is a fire sprinkler system installed?: ❑Yes ❑No /A (`1 • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal tit Describe in detail the type of work to be performed: U �y ( Fe no_ - a 6 = ..iz J V C O ••..r Florida Product Approval# for multiple products use product airgaCDog1 -N..' Property Owner Information 0 CO 0 Z a ki Namepoi/IA.4 ck A �✓L Address___, 41 7 'e-IVe•e.fe (a U V0City iL. ,,,2c State pL Zip 32Z 3�3 Phone qoq- ' �0 '"113 40 E-Mail f' wt > YKu.c.�a Lol4� O 6- CO Owner or Agent(If Agent, Power Attorney or Agency Letter Required) , /%eyZ. F— F t..• Z Contractor Information 0 N- cc w Name of Company •S.alifying Agent O al } Address City State Zip La >" a. — m Office Phone Job Site Contac. Number V i W w State Certification/Registr. ion# E-Mail Lu CC W Architect Name& Phone# LU W Engineer's Name&Phone# CC Workers Compensation Insurer OR • empt 0 Expiration Date Application is hereby made to obtain a +ermit to do the work and installations as in. ated. I certify that no work or installation has commenced prior to the issuance of a pe ' it and that all work will be performed to me- the standards of all the laws regulating construction in this jurisdiction. I understan. that a separate permit must be secured for E CTRICAL WORK, PLUMBING,SIGNS, WELLS, POOLS, FURNACES, BOILERS,HEATERS, ANKS, and AIR CONDITIONERS, etc. NOTICE: addition to the requirements of this permit,there may be additional restrictions app ..ble to this property that may be found in the .ublic records of this county,and there may be additional permits required from othe :overnmental entities such as water manage• ent 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 REC :! k OW No I E OF COMMENCEMENT. �1 (Signature of+. ner or Agent) (Signature of Contractor) J Signed and sworn to( a ed)before e this' day of Signed and sworn to(or affirmed)before me this day of l(Q.C1 , 0fAb � Wia,I'this__ LQ &— ,by .� El2. _, _f� :r.i ot. .��' (Signature of Notary) d^n t f�•, i.NI ONOLESPERcr: :.: ¢: MY COMMISSION#FF 524951 4a` EOOct r 6,2019 "'% ' Bison@MY7V1 W5, i;Unde-ente rs ' [ I Personally Known OR -- -1 - r r ',,r•-',,,,----- -19 ,,r ,,---- q r Produced Identification Type of Identification: - . /� ,S�� ��—�Ype of Identification: ''wt AF 29937 MAP SHOWING BOUNDARY SURVEY OF LOT 34, BLOCK 1 , AS SHOWN ON THE PLAT OF SEASPRAY, AS RECORDED IN PLAT BOOK 35, PAGES 64 AND 64A OF TIE CURRENT PUBLIC RECORDS OF DIIVAL COUNTY, FLORIDA. FOR: Donald Coleman-#84-J0079 "I hereby certify that I have examined the F. I .A. Official flood hazard maps and the above property lies within Zone "C" , as shown thereon. " " y 1 1 L a —T— 33 i ‘ :Iv I 6km x 0.1' I U, m 52• Al G7° j4YA �lV h a0 .' P 077. 33• ----- =I5 , �; n X0• r Ak ; v ,Itl �# CCc. l tt 1J tilt\ 1:N,, .7\ c):),., �a o I \ \ ,X, IQ 1 ' Li, .• 5. 't- ‘ \...- vl q) c.S.• . Com i..!‘ �4y� (� N N X41 r �� a c__.41 ,...1 4 • S. G 7°Z8' o (� v `VV L o 7- 35 tt CA A-10 7 .. 413 ,a /.vq 5f-. .E' To A1,ar'C ' cc)-P•c::;? �ti JOB HO �ca �17z DATE ��?/L �/ 9� �r �" �QAY, co��SON ,45SOC., QRAFTSMANQS SCALE ��— �' CITY OF ATLANTIC BEACH COPY r OWNER / BUILDER AFFIDAVIT I 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. �} ADDRESS #6, . Ae(e 5_ PHONE - � / / :DU,/U,/ L'€IV 1L j ; PRINT NAME TL.RE 1 �/�1 I DATE //n Before me this / `-� day of KD V ,20Bin 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 F( ,County of 7Th V a--- ❑Personally Known / `c !— _'7��0 —' ElProduced Identification- - �/ v Ei; Notary Signature: - °:' BordA Thiu Notary Public Underwriters F:/BLDG/Owner-Builder Affadavit;REVISED:4/16/2009