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23 FORRESTAL CIR ACC18-0070 SHED PERMIT 'Vp ACCESSORY PERMIT PERMIT NUMBER ACC18-0070 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 1/10/2019 ATLANTIC BEACH. FIL 32233 EXPIRES: 7/9/2019 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: 23 FORRESTAL CIR ACCESSORY SINGLE OR TWO 8' x 12' SHED $2230.00 FAM I LY ACCESSORY TYPE OF STATE BUILDING USE REAL E ZONING: SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: A,TLANTIC BEACH VILLA# 1717450000 01 COMPANY: ADDRESS: CITY: STATE: ZIP: TUFFSHEDINC 1116 Blanding Boulevard Orange Park FIL 32065 OWNER: ADDRESS: CITY: STATE: ZIP: ON BARLEY GEORGE 23 FORRESTAL CIR N ATLANTIC BEACH FL 32233 ALEXANDER ET 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. PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. Issued Date: 1/10/2019 1 of 2 ACCESSORY PERMIT PERMIT NUMBER ACC18-0070 CITY OF ATLANTIC BEACH ISSUED: 1/10/2019 800 SEMINOLE ROAD EXPIRES: 7/9/2019 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,JDog/Dennis Junk Removal). 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. -FEES" DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $65.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $32.50 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $2S.00 STATE DBPR SURCHARGE 4SS-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: $176.50 issued Date: 1/10/2019 2 of 2 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road -5445 C( e)- 0 U-) Atlantic Beach, Florida 32233 Pk Phone (904)247-5826 - Fax(904) 247-5845 E-mail: building-dept@coab.us Date routed: I Z /3 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z3 F C) P, e.. Department review required Yes No j5_ui I-d—in_q--��> Applicant: S H C-_L, Tree Admin—isFra or Project: "Pul I i c W__oft-�, _�ublic Utilifti_e_�> Public Safety Fire Services Review fee Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By & Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: FA"pproved. [:]Denied. ONot applicable (Circle one.) 1 Comments: PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: E]Approved as revised. F]Denied. F]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ElApproved as revised. []Denied. DNot applicable Comments: LReviewed by: Date: Revised 05/19/2017 Building Permit Applicat@f FICE CORY ated 12/8/17 City of Atlantic Beach 800 Seminole Road,Atlantic Beach,FIL 32233 Phone:(904)247-5826 Fax:(904)247-5845 Job Address: RacresA-AL Cfz-#\J XfLPrl(\T-\��Ik�ermit Number: on 7-0 -30 Legal Description, -Sb 17-41.3-99 E- A,-LL UG'Al RE# 13L-K A- Valuation of Work(Replacement Cost)$ Aa30T Heated/Cooled SIF Non-Heated/Cooled 9/a Fi_ Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door Use of existing/proposed structure(s)(Circle one): Commercial < e�identia If an existing structure,is a fire sprinkler system installed? (Circle one): Yes -No LLJ Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit oNo!Tree�Remov 0 Describe in detail the type of work to be performed: _J Z X W W 0o A _S t4kO _J L) < 0 CL Z P 0 — Florida Product Approval# for multiple products use product ap(arcol t7or w 0 Property Owner information L) a 0 N a nn e:Ge_xcu-v 16 A RA" AddressO.3 Fkre_ 4AL CIL W P < C3 C) rv- — City iz-e plic,Irk state C-L Zip _�2_7_33 —Phone 944 -412--ciSf.0 0 < P < U _J E-Mail I-_ Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) cc E) ma Contractor Information LL ILL 0 owl UJ Qua i ing Agent: M Name of Company: T_VC-�7 _5 rMID '3�AC, ))'I, Address I & 114WM�01 *600 city State 60 Zip ?ON L'u, :3 Office Phone CJ34.9,�;a-SIIJ4 Job Site/Contact Number q 0%4 -01 Sa - 9 10114 Eiji IL) 6 w— State Certification/Registration#(%(,i 15-S 164,5 E-Mail 0 it;.I kiCkryl&ow WFFSheA- Co ryX 5: M- Lij 03 > Architect Name&Phone# DIP w ISA570 Engineer's Name& Phone# Workers Compensation nWC_:5tA_-5;M(30 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 ORNEY BEFORE RECO OF COMMENCEMENT. (Signatureldfowner or Agent) (SI119atur (including contractor) Sig,ned and sworn to(or affirmed) before me thisc�!day of Signed and sworn to(or affirmed)before me this A—day of 4,0, June 2018 y Tom Saurey /jy�� 2"' Y '0m'3au I ey (Signature of Notar Signature of tary) ........... VICKI D,WILLIAMS ME LE LEVY Personally Known 9, -C ' ion#FF 974032 [VPersonally Known OR . ommiss' ,+-t:Droduced Identific [ ]Produced Identification 1).5 2020 NOTARY PUBLIC STATE OF COLORADO Type of Identificatic Type of Identification: NIA NUIARY ID 20174023626 1 My COMMISSION F:YPIR;:.-, 11 IMP 6,2021 NOTICE OF COMMENCEMENT OFFICE COPY (PRIEPARE IN DUPLICATE) Permit No. 6 L�- 0070 Tax Folio No. —7— State Of L ' A County of. uVc,�— To whom It may concern: The undersigned hereby Informs you that Improvarriants will be mada,to c*rtain roal property,and In accordance with Section 713 of the Florida Statutes,the following Information Ig statad In this NOTICE OF COMMENCEMENT. Leg BI description of property being Improved: 30-10- 11) -As-a-rle eAC,h V, 1xn',r (),LK I- Address of property being Improved: C,(Z-A/ 3 Z Z-33 General description of Improvements: Wjcrl &I,,Z-d &Y,I-z— Owner Address R)i-f e-S-k LC I 1z A/ Ar?VN4-0 c 8(,,j Z-Z 3-3 Owner's Interest In site of the Improvement c)Q,A�L 0— Fee Simple Titleholder(If other than owner Name n�E� Address Contractor Address 95 Phone No.-40- 14,14S. .1ag4lo Fax No. Surety(if any)— /1t7 Address. Amount of bond$ Phone No. Fax No. Name and address of any person making a loan for the construction of the Improvements, Norm" 4 4 , Address /yff Phone No. Fax No. Name of person within the State of Florida,other then himself,designated by owner upon whom notices or other documents may be served: Name Address Phone 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 Statutes.(Fill In at Owner*s option). Name Address Phone No. Fax No. Expiration date Of Notice of Commencement�tha amPiraflon date Is one(1)yoar from the date of recording unless a different date Is specified): THIS SPACE FOR RECORDER'S USE ONLY X65E R) signs c)ArE se Doc#2018303165, OR BK 18643 Page 478, Borare trio this—.2UJWV*f zjt,i Ag4AKa4�- J"'i —in the q �01411 at of M r,a Pe4onauy appearod Number Pages:1 heraln by Recorded 12/31/2018 0847 AM, hilr1810117 h#rss"rtd OMMIS that 811 IMMants and doelaration her4in RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL ard trua and socumte COUNTY RECORDING $10.00 NOIWY PU4110 at Larp,State, My Commission expires: pe Kw�m or C PROIDUCTAPPRCYVAL COVER SHEET 14 9 4 5 1 W SM INC-SWE OF RLMM-CBC iZS-IW As Ireqdmd by podda Statw 553-W and Podda AdmMtrafive Cub 98-72m pWse p1roWde the haomatkn an appmW mmbers for the kdMft WmPomnts MW MW if"be d&ed on the kdkft OFFICE Cop� or structum- It appmvm wo&scts are bted on One at -.*�v from he jitorcan be obtAW t WP"su Product jy Serlm FL odod*.#or fx;p,?&A;;n —Pe couaw use manubdw" slong tp Corp Panel ft9"0.5 James L RaWle parb-i F[10477.1 flood Sokitions UC Fmndatim FU759 zz- v Vents Croft Itc Series 96 FUSM5.1 Fixed Yamom tanovatkm Im FL17667 Roof uloderfavmnt Woo FL17206.2 4-, kAntries r cc�A 5,7 -mli b iq fmc-pjL- ,g ETy�peE C0910 FL10 FU7! 96 FU!il Ll :5 j- F 76 p tinnDIMM InC ,N cr SVCrimp m em(- OWe"S OD"00 10674- Asphakshiw Oakrkfge FL I rm—o A)pro&ch ftted are per MY"Buikft CO&2014 < TREE & VEGETATION AFFIDAVIT City of Atlantic Beach 1;) Department of Community Development Planning&Zoning Division 800 Seminole Road Atlantic Beach,FL 32233 (P)904 247-5800 (F)904 247-5845 PERMIT 4 SECTION I-APPLICANT INFORMATION 17- Owner(s) KLegal Authorized Agent* NAME OF APPLICANT NAME OF COMPANY ADDRESS OF COMPANY T- lte)vt-IL Co sozko PHONE CELL'JO4 j-3 kq%I EMAIL 0 -�J J---S k, co�N' CONTRACTOR CERTIFICATION NUMBER C6C I.AS71bf ATLBCH BUSINESS TAX RECEIPT NUMBER SECTION 11-SITE INFORMATION STREET ADDRESS OF PROPERTY ff an address has not been assigned to this property,contact the AB Building Department at(904)247-5826 to request an address. i,'k �- LEGAL DESCRIPTION 3 0-�S 016jE INN LOT BLOCK —1 SUBDIVISION REAL ESTATE NUMBER_Ijq-L_11, LOT OR PARCEL SIZE: SQ FT AC RESIDENTIAL V/ COMMERCIAL OTHER(SPECIFY) affirm that I hove reviewed the provisions of Ch NNW& ANKL A apter 23, "Protection of Trees and Native Vegetation" of the Municipal Code of Ordinances for the City of Atlantic Beach, FL andlor I have participated in a pre_application meeting with the Administrator of those regulations. Subsequently,/affirm that no regulated trees and no regulated vegetation will be damaged, destroyed andlor removed from the above d r* or yadc—eni ro es in conjunction with this project. SIGNATURE OWNER SIGNATURE OF OWNER Signed and sworn before me o(n this 9; day of j)pCt,,6 r "Y State of 12q, County of Identification verified: —&kLLKA—� Oath sworn: Yes F- No Nolary Signature ,!,lcommis$104F MYC Vz onn MIss REV-TVA-viv.12 MY Commission expires: City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road t ntic Beach, Florida 32233-5445 0 [a Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: Z /3 City web-site: http://viww.coab.us APPLICATION REVIEW AND TRACKING FORM f op , R& Property Address: Z3 STA,�_ etlZ, Department review required Yes N Xjru�i�lding _P Ita ff n—Fin g—T 7 3—ni M T- Applicant: SHC-_F-_) Tr e AdminisFraTor Project: —Public EUt 0,,irt!i e� 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: )ZApproved. []Denied. E]Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:ie= "20= Date: TREE ADMIN. Second Review: F]Approved as revised. ElDenied. []Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. E]Denied. E]Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 '5 City of Atlantic Beach APPLICATION NUMBER EGEN k:: (To be assigned by the Building Department.) Building Department 800 Seminole Road ocao Atlantic Beach, Florida 32233-5445 IAN 0 2 -"3 Phone(904)247-5826 - Fax(904)2 9 84V Date routed: Z 1,3q I B E-mail: building-dept@coab.us City web-site: http://www.coab.us BY:-- APPLICATION REVIEW AND TRACKING FORM F-(:) p t\J - , p Property Address: Z 3 Department review required Yes No 4Eu i 71d_in_�—� Applicant: S H C—__F-� ,,Plarf n--in g—K-787ri-I Ng-, Tree Admiffi�isra 6r _06- Project: ublic W rR-S-� _Qp�ubflc U�filitie 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 1z 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: [;�A`pproved. FIDenied. E]Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by., Date: 7Ze TREE ADMIN. Second Review: []Approved as revised. ElDenied. E]Not applicablel PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. E]Denied. E]Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road 0 o? Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 L Date routed: il: building-dept@coab.us E-ma City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM NJ Property Address: Z 3 0 R ,,.TA.- e.. Department review required Yes N 4:ffuu�flding .,_Rb'ff-ni_n _T7_o_n-i ng- Applicant: SHC-_F'� g— Tree Adminis�ra or Project: \Y, S' Work-g� UtLifiti3e > 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. MNot applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed b /4__�_Date: _z- TREE ADMIN. Second Review: E]Approved as revis F]Denied. F]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ElApproved as revised. E]Denied. E]Not applicable Comments: Reviewed by: Date: Revised 05/19/2017