606 COASTAL OAK DR - ROW -;------,1=-.;9--,----,,,.,,,,
RIGHT OF WAY PERMIT PERMIT NUMBER
ii CITY OF ATLANTIC BEACH ROW18-0041
')r ISSUED: 12/5/2018
800 SEMINOLE ROAD
gjilr- % ATLANTIC BEACH. FL 32233 EXPIRES: 3/5/2019
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:
RIGHT OF WAY SINGLE OR TWO Install Pipe used for Aeration
606 COASTAL OAK LN $0.00
FAMILY RIGHT OF WAY System
TYPE OF REAL ESTATE ZONING: BUILDING USE I SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169505 2010 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
Charles Aquatics, Inc. 6869 S Phillips Pkwy Dr Jacksonville FL 32256
OWNER: ADDRESS: CITY: STATE: I ZIP:
ATLANTIC BEACH 414 OLD HARTS RD STE 502 FLEMING ISLAND FL 32003
PARTNERS LLC
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.
Issued Date: 12/5/2018 1 of 2
""‘:11-An-i-e RIGHT OF WAY PERMIT PERMIT NUMBER
r ROW 18-0041
,.,,,,
CITY OF ATLANTIC BEACH
V" ISSUED: 12/5/2018
��; D''' 800 SEMINOLE ROAD EXPIRES: 3/5/2019
ATLANTIC BEACH. FL 32233
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.
4 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL
Notes:
Any infrastructure damaged must be replaced by Contractor.
5 PUBLIC UTILITIES UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL
Notes:
Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field
coordination is needed,call 247-5878.
6 PUBLIC UTILITIES UTILITY MAP INFORMATIONAL
Notes:
See attached Utility Map.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
TOTAL:$25.00
Issued Date: 12/5/2018 2 of 2
rr
CityofAtlanticBeach CE ,� APPLICATIONNUMBER
�, Building Department (To be assigned by the Building Department.)
_ ri 800 Seminole Road -
-0 Atlantic Beach, Florida 32233-5445 1 0 �' " 004/
__ Phone (904)247-5826 • Fax(904)247-5815 O/
\o;1 0- E-mail: building-dept@coab.us I��':___...__._.__.__.______. Date routed: (/2 / i'
City web-site: http://www.coab.us !!1
APPLICATION REVIEW AND TRACKING FORM
Property Address: B3 rxU at £ Oio Ciba ( Department review required Yes No
Building
Applicant: Chirte s NI iKQeic s Manning &Zonin
Tree Administrator
Project: e k 1 Pte r \ n S+Ct -py� Public Works
P Public Utilities
51
St-e rh u is afety
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' e)r624040," Date: ��%lf;�o
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. I Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
)_.114r,, City of Atlantic Beach 1ECEIVE APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
i, 800 Seminole Road NOV ry 6 2018 O W t. ' ' Cj' 004/
Atlantic Beach, Florida 32233-5445 Q
Phone(904)247-5826 • Fax(904)247-5 G l
E-mail: building-dept@coab.us Date routed: ` (// 2-d//
ik
City web-site: http://www.coab.us /// 111
APPLICATION REVIEW AND TRACKING FORM
� /- /1 '4 KS Li');
Property Address: b r d c _t `� oto � oaSizt( Department review required Yes No
Buildin_g
Applicant: Cho..r(.e S l&d-` 1C S Planning &Zoning
Tree Administrator
Project: tis &U t -c-o( 1\e1o2rt Public Works
Fe
Public Utilities
sf-e Public Safety
Fire Services
Review fee $ Z 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:
APPLI9'fION STATUS
Reviewing Department First Review: 117 proved. I 'Denied. Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: — 1/— 8—
TREE ADMIN. Second Review: ['Approved as revise Denied.
❑ pp � � ['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
;f .a,,,p;. i City of Atlantic Beach APPLICATION NUMBER
0 , � Building Department (To be assigned by the Building Department.)
r '�' 800 Seminole Road y. '
�.. ��� Atlantic Beach, Florida 32233-5445 V�/ I �Q /
Phone(904)247-5826 • Fax(904)247-5845 0
1�f; E-mail: building-dept@coab.us Date routed: ( 2 le
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
C-04.514(/ 4 KS Ln
;�
Property Address: b r d CA -t 6 O Department review required Yes No
Building
Applicant: C,hctr(es PI Planning &Zoning7
Tree Administrator
Project: Ins--cat ix' Fe '$'r Ae 1c Public Works
r Public Utilities
S1
si'-c� u is afety
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. applicable
(Circle one.) Comments: )21ot
BUILDING
PLANNING &ZONING I/--2. —
Reviewed by: L 1 ' Date:
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
,Z '' ;,. Building Permit Application Updated 10/9/18
,ea\
City of Atlantic Beach Building Department *Au INFORMA ION
800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
u,at�� Phone: (904)247-5826 Fax: (904) 247-5845 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 606,Coastal Oaks Ln Permit Number:R MVV I U OD Lii
Legal Description RE#
Valuation of Work(Replacement Cost)$7 5() Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ' iNew [Addition ❑Alteration ❑Repair ❑Move ❑Demo OPool ❑Window/Door
• Use of existing/proposed structure(s): riCommercial Residential
• If an existing structure,is a fire sprinkler system installed?: QYes JNo
• Will tree(s)be removed in association with proposed proiect?DYes(must submit separate Tree Removal Permit) PIN,
Describe in detail the type of work to be performed:
Install 1" PVC pipe used as air supply for Aeration System
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name,14.,77c Bec.4 47/...,-71.--7 G/Lr //01 Address /4/&fci/{.rr ,c. rU,/e XV
City r✓e7,-,i /a-vel State / L Zip '3 2-003 Phone 990Y-/—S 9.2—yo 9a
/L�
E-Mail ,/t 1/c°r-r. ce.474e`'n'`�
Owner or Agent iS Agent,Power'of Attdrney or Agency Letter Required) n/a
q )
Contractor Information
Name of Company Chartes Aquatics inc Qualifying Agent James FI.Charles Ill'
Address 6869 Phillips Parkway Drive South City Jacksonville State FL Zip 32256
Office Phone (904) 997-0044 Job Site Contact Number (904) 803-3669
State Certification/Registration# E-Mail fountain@charlesaquatics.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer Bridgefield OR Exempt 17 Expiration Date 05/15/2019
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 regulating
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 ING YOUpIOTICE OF COMMENCEMENT.
fa/ez.Azix:6 ?' K_ CI-J>e----TIk
(Signature of Owner or Agent) cy (Signature of Contractor)
Signed�� and sworn to(or ffirmed)before me this,() day of Signed and sworn to(or affirmed)before me this 2U day of
/ /e.- 4' , Zr/X,b _ ,Aii I�( 1�1 20�v by CICS +1/
f:,,, ;7 . '7
(Signature of Notary) (Signature of Notar
personally Known OR :elk WILLIAM K MEAGHER I[ I Personally Known OR UDGRAY
[ )Produced Identification :•, .: Produced Identification +. ;• CommissbnQG118233
. MY COMMISSION#FF957454 / )1
Type of Identification: Type of Identification: n @ Expires JanU 2$,2022
T e V�-'�'i,,,,t Doodad R►rT yFoYtMwmosa00,1 700
,
44�+:f9Mo'a:, FlontlalloG�Sarvkw,con. """'e .
"4-r,,N; RIGHT-OF-WAY/EASEMENT PERMIT APPLICATION **ALL INFORMATION
, City of Atlantic Beach HIGHLIGHTED IN GRAY IS
800 Seminole Road, Atlantic Beach, FL 32233 REQUIRED.
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address 606 Coastal Oaks Lane Permit Number
Contractor Information
Company Charles Aquatics,Inc. Qualifying AgentJamesH.Charles Ill
Address 686 Phillips Parkway Dr S CjtyJacksonville° State FL Zip 32256
Phone(g04)991-°a44 44 Email fountain@charlesaquatics-com
State Certification/Registration It
Architect Phone Email
Engineer - Phone Email
Workers Compensation Insurer Bridgefield OR Exempt®Expiration Date 05!15/2019
• 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 Public Works Director,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 Public Works Director and at the expense of the
Permittee unless reimbursement is authorized.
• All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the
supervision of Jeft Jackson (Project Superintendent)
with(Company Name) Charles Aquatics,Inc. Phone(904)803-3669
• All materials and equipment shall be subject to inspection by the Public Works Director.
• 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-30 - days. If the beginning date is more than 60
days from date of permit approval then permittee must review the permit with the Public Works Director 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 harmless 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 Public Works Director s II be notified 24 hours prior to starting work and again immediately upon completion.
E� : ". Date 1!r 2 0-1ti,
;
Permittee(signe n presence of Notary Public)
STATE OF FLORI ,COUNTY OF DUVAL
The foregoing instrument was acknowledg this 2.0day of ,20 IS. ,
by < i l s.M*} H, C lekoAt kho personally appeared before me and
(printed name of Permittee
•acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. :': ,, RASHAUDGRAY
1• ;=Commission#GG 178233
W rA fo
r Expires January 23,1022
`?° net Banded Thu Troy Fun Immanuel/JO-385401f
[ ]Personally Known .
Signature of Notary Publi tate of Florida [i Produced Identification(Type)
H:\Applications&Forms\Word Documents\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18
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