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311 17TH ST - PAVERS, DRIVEWAY, SIDEWALK ACCESSORY PERMIT PERMIT NUMBER (,-,,iyypi.,,, 1 r;» CITY OF ATLANTIC BEACH ACC18-0055 Vry800 SEMINOLE ROAD ISSUED: 1/7/2019 ' ATLANTIC BEACH. FL 32233 EXPIRES: 7/6/2019 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: ACCESSORY SINGLE OR TWO REPLACE CONCRETE 311 17TH ST FAMILY ACCESSORY DRIVEWAY AND SIDEWALK $9000.00 WITH PAVERS TYPE OF REAL ESTATE I BUILDING USE CONSTRUCTION: NUMBER: I ZONING: GROUP: SUBDIVISION: 172020 0244 SELVA MARINA UNIT 06 1 COMPANY: ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ZIP: RUDEN ANN V 311 17TH ST ATLANTIC BEACH FL 32233-5811 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 EROSION CONTROL INSTALLATION INFORMATIONAL Notes: Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(904-247 -5814)to request an Erosion and Sediment Control Inspection prior to start of construction. 2 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. Issued Date: 1/7/2019 1 of 2 ACCESSORY PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH ACC18-0055 J 800 SEMINOLE ROAD ISSUED: 1/7/2019 \ ox»• y EXPIRES: 7/6/2019 ATLANTIC BEACH. FL 32233 3 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. 4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. 5 PUBLIC WORKS MAXIMUM DRIVEWAY INFORMATIONAL Notes: Maximum driveway width within the City right-of-way is 20 feet. 6 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL Notes: This permit is for removing and replacing ONLY. No additional impervious area is permitted. 7 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. 8 PUBLIC UTILITIES METER BOX SEWER CLEAN OUT INFORMATIONAL Notes: Ensure all meter boxes,sewer cleanouts and valve covers are set to grade and visible. DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT 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 ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $50.00 TOTAL: $79.00 Issued Date: 1/7/2019 2 of 2 Sy>>,i�� City of Atlantic Beach APPLICATION NUMBER J'r �' ' ,J, � Building Department (To be assigned by the Building Department.) '- . . 800 Seminole Road. i•?, E1 E , v �e Atlantic Beach, Florida 32233-5445 odS 5 Phone(904)247-5826• Fax(904)247-5845 / 0;i» E-mail: building-dept@coab.us NOV to routed: I I / �l City web-site: http://www.coab.us J 2U ! 8y._ APPLICATION REVIEW AND TRACK NG FORM Property Address: 8 1 L7 -I -its ent review re•uired Yes No lira------- Applicant: &Zonin• Applicant: � 1\)64e.._ Ell Tree Administrator MEI Project: R LAC G. eo/�L.P- TE— 4 -•• is ►for -- S t 0 Et,0 pt-c,l-<_ k--. fz( 0-€.1A-) A c-f ' 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: I VI/Approved. I IDenied. ❑Not applicable (Circle one.) Comments: BUILDING (i&2 PLANNING &ZONING Reviewed by: — Date: 1/-9-1r TREE ADMIN. Second Review: Approved as revi d. ❑Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ['Denied. I INot applicable Comments: Reviewed by: Date: Revised 05/19/2017 PUBLIC UTILITIES PLAN REVIEW COMMENTS Date: Application it:/4C(�/ Project Address: 3/ 7 tk Check Box Check APPLICATION TRACKING COMMENTS to Add Box to Commen Print Underground Avoid damage to underground water and sewer utilities. Verify vertical and ,f Water Sewer horizontal location of utilities. Hand dig if necessary. If field coordination is [71 Utilities needed,call 247-5878. _ ff Meter Boxes Ensure all meter boxes, sewer cleanouts and valve covers are set to grade Sewer Cleanout and visible. A sewer cleanout must be installed at the property line. Cleanout must be RT1 Sewer covered with an RT1 concrete box with metal lid. Cleanout to be set to grade 0 ❑ Cleanout and visible. A reduced pressure zone backflow preventer must be installed if irrigation will RPZ be provided or if there is a private well on the property. Backflow preventer ❑ ❑ Backflow must be tested by a certified tester and a copy of the results sent to Public Utilities. Plans note the building will be unsprinkled. If plans change, any fire line Sensus installed must be metered with a Sensus touch-read meter in a properly sized Touch-Read vault and an appropriate backflow preventer installed. Backflow preventer 0 0 Meter must be tested by a certified tester and a copy of the results sent to Public Utilities. Fire Sprinkler Backflow If fire sprinkler system is provided, call 247-5878 for backflow requirements. 0 0 Requirement At a minimum,will require a double check backflow preventer. Fire Line Fire lines must be metered with a Sensus touch-read meter. Meters larger ❑ ❑ Meter than 2" must be installed in a vault as noted in JEA specifications. Utility Map See attached Utility Map. ❑ 0 Disconnect &Cap Disconnect and cap water and sewer lines. 0 0 Inspection Must call the Inspection Line at 247-5814 to request an inspection of the Prior disconnected and capped water and sewer lines prior to demolition. ❑ ❑ ❑ 0 ❑ ❑ ❑ 0 O 0 111 � 1..A.N,,.. City of Atlantic Beach APPLICATION NUMBER �f Building Department• (To be assigned by the Building Department.) l A 800 Seminole Road R2QJS - 005 5 �_, +"r Atlantic Beach, Florida 32233-5445 '" Phone(904)247-5826• Fax(904)247-5845 ''.('J, gr E-mail: building-dept@coab.us Date routed: i 1 ( 5/ ( S City web-site: http://www.coab.us / APPLICATION REVIEW AND TRACKING FORM Property Address: 8 17 rt; ent review required Yes No Fecframmumm Applicant: CD LC (3 EP 7`;--ronin. & Zonin• -- Tree Administrator Project: RCpO LAO,E ( d/'DC 7"e- -.. lc 'Tor iiatatitElliTh— ___ 11111111 S t 0 (� Pr-C--k.-<— ..- 4� Z( vim)lA- : Public Safety _- W .(. Y ei P f L 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: Opproved. ❑Denied. fNot applicable (Circle one.) Comments: BUILDING • PLANNING &ZONING Reviewed by: , - Date: '/ —e— I se 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 IJ'J ;.iJ City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 1 ;_ 800 SeminolecRoad t, ��., - OC25 j.. ._ �� Atlantic Beach, Florida 32233-5445 �'j\/ �� " '`` ' Phone(904)247-5826 Fax(904)247-58 A/ r E-mail: building-dept@coab.us f ioV Date routed: I t City web-site: http://www.coab.us 9 ��18 APPLICATION REVIE 'AND---TRA_ ING FORM Property Address: 8 t - !-rt, ent review required Yes No Applicant: � O (� _, n n• &Zonin• _- pp Tree Administrator �- Project: R,p,p,o_E �C;'S�I�C 7`�- � '�• IC r!or — .1111111111 0ei-A-D A-C AK_ 2( OCA-) • Public Safety -- Fire Services LJ,) c 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. [enied. ['Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed b Date: "I-, TREE ADMIN. Second Review: VfApproved as revised. ['Denied. ['Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed • ;:/„ e/ Date: ll 100 FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. ['Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 01.1vIj'.4., City of Atlantic Beach APPLICATION NUMBER it BuildingDepartment (To be assigned bythe BuildingDepartment.) 1 800 Seminole Road � �� Rale, - 0c55 15...:.R Atlantic Beach, Florida 32233-5445 ��„ Phone (904)247-5826 • Fax(904)247-5845 �r ��`` (. 0. E-mail: building-dept@coab.us NOV 9 2�� to routed: 1 / Vs City web-site: http://www.coab.us 111 APPLICATION REVIEW AI1TRAG NG FORM Property Address: k ` 7 D- s.rt! ent review required Yes No gil�.ill'! 4 Applicant: ;-snin• &Zoning _- �L,C7 (�C`2 , Tree Administrator Project: L4� �/NCA . ic +nor algrantgli L etAD L—& v€w Public Safety L ‘D c 7 f{ PA42--.S 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: APPLI ION STATUS Reviewing Department First Review: Approved. nDenied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: – � "Date: 1/— TREE TREE ADMIN. Second Review: ['Approved as revi d. ['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 N Building Permit Application Updated 12/8/17 4 City of Atlantic Beach v Iii. 800 Seminole Road,Atlantic Beach,FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 l�� Job Address: 31/ /7' £74-44-#44- 41//bhi)4e-,�E"`�� -PermitNumber: `? IS' 0CISS Legal Description RE# 17 20 Z0-OZ 4' y� Valuation of Work(Replacement Cost)$ �pr/Q' Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteratio Re..• Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial - !-M • , • 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: " -'' '144.0-4.---1,1, L", /A", /�/Z`r' '" '.''t /,,mow;Z.-, 6X<l'-1, f re444 - , Florida Product Approval# for multiple products use product approval form Property Owner Information Name: fI/eA" 1//9 -1,- Og'-/ Address: .p// /7&#S',1-441"‘"1 • City AA/ii •c- z /-"h- State,/ Zip 11273 Phone VUV ST6 -e'a`e v/ E-Mail 4tV!" 6-4-1471Ca:-•-,eN-S,1. •v.-4. Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) Contractor Information Name of Company: Qualifying Agent: Address City State Zip Office Phone Job Site/Contact Number State Certification/Registration# E-Mail Architect Name& Phone# Engineer's Name&Phone# Workers Compensation 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 RECORDING YOUR NOTICE OFw,QMMENaltENJ.v 01/V rVPt) „�; CHERYLJEANAN�AofFl �' Notary Public-State of Florida • • ''” 1 Commission 0 GG 128671 T. v I (Signature of (Signature of Owner or Ag ritV; �: My Comm,Expireslul26,2021 ( g Contractor) (including contractor ..c.sN` BondedIhruughNalionaINolaryAssn. Sigrid and sworn to(or affirmed)before me this ay o Igne a worn to(or affirmed)before me this day of NOV 1.016 ,p CO-all( 121 , ,by Lk6OilatAZ (Signat of Notary) (Signature of Notary) [ I Personally Known OR [ ]Personally Known OR [,'roduced Identification [ ] Produced Identification Type of Identification: (%L b!"'" Type of Identification: �,',. CITY OF ATLANTIC BEACH J' S1J Department of Public Works `� sl 1200 Sandpiper Lane \--1 '' Atlantic Beach, FL 32233 rJ�SI % (904) 247-5834 www.coab.us PUBLIC WORKS PLAN REVIEW COMMENTS Date: 11/15/18 Applicant: Ann &Alex Ruden Permit#: ACC18-0055 Email: annruden@comcast.net Review Status: DENIED Site Address: 311 17th Street THIS PLAN REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS Correction Items must be submitted to the Building Department at 800 Seminole Road. Submittals that respond to only one or a few correction items will not be accepted. Revisions may not be submitted until ALL departments have completed their respective reviews. Revisions must be submitted to the Building Department and must respond to EACH department review. PUBLIC WORKS CORRECTION ITEMS: APPROVED • A Revocable Encroachment Agreement must be submitted. The form is on our website under Building Department - "Permit Applications and Forms" g and also at the Building Department located at City Hall. `1',Z,/.4e) PUBLIC WORKS CONDITIONS OF APPROVAL: (The following comments will be printed on your permit as Conditions of Approval) • Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line (247-5814) to request an Erosion and Sediment Control Inspection prior to start of construction. • All runoff must remain on-site during construction. • 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. • Full right-of-way restoration, including sod, is required. • Maximum driveway width within the City right-of-way is 20'. • The permit is for removing and replacing ONLY. No additional impervious area is permitted. Scott Williams, Public Works Director swilliams@coab.us/904-247-5834 Page 1 of 2 O:\Public Works\ADMIN\PLAN REVIEW COMMENTS\ACC18-0055(Ruden-Owner).docx Resubmittal Notes: All revisions and changes shall clearly stand out from the rest of the drawing on the sheet as a revision by way of completely encircling the change with "clouding". The revision shall also be identified as to the sequence of revision by indicating a triangle with the revision sequence number within it and located adjacent to the cloud. The revision date and revision sequence number shall also be indicated in a conspicuous location in the title block for each sheet on which a revision for that sequence occurs. For projects still in the initial review stage and permit pending, all sheets with revisions shall be inserted into each set of drawings. The original sheets must be clearly marked "VOID" but are to be left within the set of drawings. Complete new sets of drawings will not be accepted. ADDITIONAL ITEMS MAY BE REQUIRED DEPENDING UPON NEW INFORMATION AND CLARITY OF FINAL PLANS SUBMITTED FOR REVIEW. Page 2of2 0:\Public Works\ADMIN\PLAN REVIEW COMMENTS\ACC18-0055(Ruden-Owner).docx Revision Request/Correction to Comments **ALL INFORMATION HIGHLIGHTED IN i�� City of Atlantic Beach Building Department GRAY IS REQUIRED. r 800 Seminole Rd, Atlantic Beach, FL 32233 - Jaw Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: CG - c0SS 1 Revision to Issued Permit OR El Corrections to Comments Date: J/2c. -.2c►/e Project Address: 3// /7 7//s/41 - Contractor/Contact Name: /4,2f4.1 , (/cL�'✓ // Contact Phone: I/6 h'ST(0 " geg� Email: Al^JA/R•'(13-^/ 62 CdryGs �,t•./C1/— Description of Proposed Revision/Corrections: ,?i- vo C4/3/ 6eo4/ #u -# iI14,4/ 's1 /-.<1 I A A.A., ye affirm the revision/correction to comments is inclusive of the proposed changes. (printed name) • Will proposed revision/corrections add additional square footage to original submittal? ENo n Yes(additional s.f.to be added: • ill proposed revision/corrections add additional increase in building value to original submittal? *Ail! n*Yes (additional increase in building value:$ )(Contractor must sign if increase in valuation) *Signature of Contractor/Agent: (Office Use Only) TZpproved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$ Revision/Plan Review Comments Department Review Required: Building Planning& - Reviewed B Zoning FEC EIU .t y Tree Administrator Public Wor s > NOV 2 6 2018 i u is Utilities 71-644'(0" Public Safety BY: Date Fire Services Updated 10/17/18 pv-n..,4,,;.\- 4 C c 1 _c o S S "AP' "' REVOCABLE ENCROACHMENT AGREEMENT J; r', City of Atlantic Beach **ALL INFORMATION 800 Seminole Road,Atlantic Beach,FL 32233 HIGHLIGHTED IN GRAY \' �/ IS REQUIRED. °stip-� REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of t e State of Florida, hereinafter referred to as"CITY" and Anti /Qv ,,L 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 IQ6'1417f- 1--/e/-11/4-G' /),G•l.F-t--/ / Any facility maintained, repaired, erected, and/or installed in the exercise of theprivilege 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 mil,return receipt requested,to the following address 3/1 /7 71/4 Sis 4// 'c'h . 4 / • 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 liab"lities are here y assumed by the USER. -jj�--04--""/ Date !/!/`��U//4...../g/ Property Owner/Agent(signed in presence of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL The foregoing instrument was acknowledged this 1W day of 01)1.al t.btr , 20 l , by 1 � ,who personally appeared before me and (printed name of Signer) acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. Cj,{,� ` ben_ k . Department Approval: Signature of Notary Public,State of Florida Nei, ,,. CHERYL JEANBARRER /�� Notary Public-State of Florida [ ] Personally Known f,l i • Commission a(G1286/9 � Lii w _ S: ,$ Produced Identification(Type) RIX.. •...'frx otir� My Comm.Expires Jul 26,2o2,co`t Williams, Public orks Director ...,,, Bonded through National Notary As 41 H:\Applications&Forms\Word Documents\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18 • RIGHT-OF-WAY/EASEMENT PERMIT l'40;l0r Permit# Issued by the City of Atlantic Beach PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES Job Address 7// /71 t �'��% Phone fir-5-5-6 — Permittee 4/,gyp L•4ti'v/G �`'� Email Xwal/4'14.'`j 447'""e111731: Requesting Permission to Construct leer~4631""3 LO''"4044 401,07 `4'/Ii 3 z 4Gj Location(Reference to Cross-Street) • 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 Director of Public Works,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 Director of Public Works 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 (Project Superintendent) with Company Name Phone • 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 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 days. If the beginning date is more than 60 days from date of permit approval then permittee must review the permit with the Director of Public Works 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 Director of Public Works shall be notified twenty-four(24)hours prior to starting work and again immediately upon completion. 041Athilf‘) Date /Veit Permittee(signed in presence of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL I_ Aft The foregoinginstrument was acknowledged this l9 day of Nt V ,20 byA1 ,who person. •., . . ' (printed name of Permittee) ......... CHERYL JEAN BARBER ?_� � Notary Public-State of Florida acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. ` ,; Commission•1 G11286/9 •411A,10.V1 %m• �f Mtlmded ihtagftN�i,TI�PJolary(A?v,. V Personally Known Signature of Notary Pu lic,State of Florida Produced Identification(Type) ' ,„•11_.1PJ„:, CITY OF ATLANTIC BEACH WNER / BUILDER AFFIDAVIT ` � U;f1a ® 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. Y// /7/// ;f/cam- 117 /91•x/,// 49_ci – rPrk ADDRESS PHONE NUMBER /4/ .-y I4 f A/n/ ,Z✓dw PRINT NA E ��C�� } ! /- . 6-ie / „/ SIGNA Rt�i�� DATE 7(5/ Before me this (,7 'day of Na V ,20 L. in 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 1 ,County of (]Personally Known "i;; '''''•''' CHERYL JEAN BARBER c. ' s� n.•, Notary public-State of Florida roduced Identification- JI -•; *•i Commission I GG 128679 0 q6Clik: V> r;47• My Comm.Expires Jul 26,2021 ,...4)-i/A6' cc..... Nondedthrough National Notary Assn. Notary Signature: F:BLDG/Owner-Builder Atfadavit;REVISED:4/16/2009 • • . ;iv., 1 } f' OQ.. ti ,.a� *.I.9.1) ,y.. a7 r o G.r --- • .y r o 1 '21\ i • a.r o ¢I} 7 Fla �� i nl L. Kv • �j� ` 1^�t� O mar ;o,j ��: o .�:' ;1.a � �{� \\.' t7� 4 ,- OU ''•J� \�1� V ._ 1 •LLs.1-_- \ ‘•:: \ ci-' • .. ...:.....-... - %. , -. 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U O Z 4 • OW m Q NT - O Y 2O; J S a� W o w Qe d O -0 iy ^ a n.c= c '" = o z_ • QdOp , O M � O r— Q .. 00 2�� _ J', •S o NLL w Ci OHO '"c-- •: a �i n s oc n��' � '�� al a W ZZ ti v T + �i yo• �+u s=¢30ca°-fa ob.ci'm.2 7.3.z, WZZ . - � � I� • • CSN eel /earn cR• eolL et : a , - 7. N W (.) (n U re Q d u •. c, Ntox id 4 �' �i u 7 H tar 4 ecJ'C_; lru<¢.u�oa�cw 5Ti• . . tt I 16 L i � L ECT B 1 C/sq_ ffL14J--A I/ z T General Structural Notes: Florida Building Code 2017, American Concrete Institute, American Institute of Timber Construction, 2. Live Loads-. Roof: 20 psf Floor: 40 psf Stair: 40 psf 3. Afflnd Load Notess Codes: Florida Building Code 2017 and ASCE-7-10 Ultimate Design Wind Speed: 130 mph Wind Importance Factor: i = 1,0 BWding Category: 11 Wind Exposure: C Enclosure: Enclosed Building Internal Pressure Coofficient GCPI 18 or -.18 Wind Pressure to Corhiponentsl Claddings (Mean Roof Height 26) End Zone = 8 Zone Effective wind areas f) _ Wind LoqdR(psq Positive Suction Interior 10 +41.0 -44.5 20 +39.1 -42.6 50 +36.7 -40.2 100 +34.9 -383 End Zone 10 +41,0 -54.9 20 +39A -51.3 50 +36.7 -46.3 100 +34,9 -42.6 NOTE AWS Design Pressure Ultimate Pressure x 0.6 or Divide with 1.6 4. Aflowable 8aill bearling,. 2500 psf Soill Comipaofflon.- Soil under slab on grade and foundation shall be compacted to 95% modified proctor max, dry density (ASTM D-1557). Contractor shall submit density test report to Owner or Engineer, Concrete (normal weight- 28 days) 3000 psi Reinforcing bar ASTM A615 Welded Wire Fabric ASTM A185 Anchor Bolts ASTM A36 Welds AWS E70 or E60 Wood Members for beams & Posts (92 SYP) Wood Members for studs (#2 SYP or better) Microllam 1.9E 7. Conaret e-0 All concrete to be designed as per ACI 318 Latest Edition, Footings , 3000 psi Slab on Grade 3000 psi All others 3000 psi Splice;; in reinforcing where permitted: Concrete 60 bar diameter Masonry 48 bar diameter Unless shown on drawings, minimum conc. cover for reinforcing: Cast against earth 311 Slab on grade Centered Exposed to earth or weather #6 thru 411 bars 2" #5 bars & smaller It 1/2" All reinforcingshall be held securely in position with standard accessories in accordance with ACI 3,15 during placement of concrete. 8. TlImber-e All wood frarning shall be fabricated and installed as per AITC & TPI & National Design Specification for Wood Construction, Provide temporary top chord bracing until roof sheathing is in place. All wood members exposed to weather shall be pressure treated. Pre-engineered wood trusses shall comply with Truss Plat Institute Standard with proper dead, live and wind loads. Drawings shall be signed and sealed by professional engineer registered in the State of Florida. Provide hurricane clips at both ends of each rafter and truss. The number and size of nails connecting to wood members shall not be less than those specified in FBC 2010 Table 2304.9.1 Fastening _J L E:C-A PE WP ViP-tcK 61?. VIA1,4- wi-rH Square Footage InFormation-, is Florida Building Gode 2017. FIR5T FLOOR, "Existing BuildIng" UNDER, ROOF 5F F1 5T FLOOR.- HEATEED f-IC--rHOP DF - W/A 5F GAR ( -E -UNHEATED 5F FRONT POROH W/A 5F BACK PORGH Reinforc.Ing Bar K 5F SECOND FLOOP, Melded Hire Fabrir. 5ECOND FLOOR,-- HEATE51 HolloN Load Bearing GMU iN /A 5F TOTAL HEATE-D ASTM A50-7 or A36 I\VA. 5F StructUrise HeIght 4 Number of torr es: Mean Roof Height (#2 5`rP or Better) Mirrollorn Number of 5torjeE, Type of C�rlstructjon: Type, \/E3-2 Unprotec,tod Unsprink led occupanc� Residential Group R,5 Project Stupe: Project Area Information-. Site, Area �-,J/A SF Orive, � Forche,5 5F Total Mouse 5F Total Pro used Lot Govern 1\1 //,-. 5F Proposed Lot', Goveroge IN /A Applicable Codes: is Florida Building Gode 2017. Florida Building Code 2017. 5th Edition - "Existing BuildIng" National Electrical Gode 2014 - National Fire, Prevention Godo 2012 f-IC--rHOP DF - Materia Is-. Gonc,rete (Normal Height- 28 mays) 3000 Psi Reinforc.Ing Bar ASTM A615, 6r6O Melded Hire Fabrir. ASTM l85 HolloN Load Bearing GMU ASTM CAO, Or N-1 A Anc-hor Bolts ASTM A50-7 or A36 Holds ANS F-70 or E60 Hood Members for Beams Posts (#2 SYP) Hood Member5 for Studs (#2 5`rP or Better) Mirrollorn IAE Ei EG. LE JE + HO -VOLT X20 aw 220 -VO! -T OV-ILET 0J HO 4_4 47 vEjLits 1 J T F I X Z - r I r— FIROJEC', T DATA e,p# DATE 5- J S SIGNED is Existing Floor Plan l e c p. f55i fel �! C-00 )o. ,i ov, REVISION BP# pbsl9 0/ t15 - DATE 5-/// / / SIGNED OFFICE COPY (L Q SL v �u � � Q x r