1101 BEGONIA ST FENCE PERMrir'ilari FENCE WALL OR BARRIER PERMIT
J; p1
CITY OF ATLANTIC BEACH
V 800 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233
PERMIT NUMBER
FNCE19-0004
ISSUED: 3/1/2019
EXPIRES: 8/28/2019
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:
1101 BEGONIA • •• C••• . 41111
171022 1000
ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: STATE: ZIP:
ROMANO ELAINA 200 TROTTER RD #426 WEYMOUTH MA 02190
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.
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, JDog/Dennis Junk Removal, All American Roll Off, WCA Waste Corporation). 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: 3/1/2019 1 of 2
FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH FNCE19-0004
800 SEMINOLE ROAD ISSUED: 3/1/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 8/28/2019
1 4 1 PUBLIC WORKS I FENCING REMOVED I INFORMATIONAL
Notes:
All old fencing must be removed from job site by Contractor.
DESCRIPTION
ACCOUNT
QUANTITY
PAID AMOUNT
BUILDING PLAN CHECK
455-0000-322-1001
0
$17.50
BUILDING PLAN REVIEW RESUBMITTAL SECOND
455-0000-322-1006
0
$50.00
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: $131.50
Issued Date: 3/1/2019 2 of 2
City of Atlantic Beach
Building Department
800 Seminole Road
Y ` Atlantic Beach, Florida 32233-5445
Phone (904) 247-5826 Fax (904) 247-5845
`r� �ntl,�;• E-mail: building-dept@coab.us
City web -site: http://www.coab.us
APPLICATION NUMBER
(To be assigned by the Building Department.)
19-00o4
Date routed.-
APPLICATION
outed:
APPLICATION REVIEW AND TRACKING FORM
Property Address: I (o ( 'R C—,cr j�j I
c
Applicant: CD
Project:
Review fee $
Department review required Yes No
-17Milding 7D
anning & Zoning
Tree Administrator
is Wor
lic Utilities
ublic Safety
Fire Services
Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
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:
APPI I(` -A- r-nN -RT®TI IQ
Reviewing Department
First Review:
Approved.
❑Denied.
(Circle one.)
Comments:
BUILDING
PLANNING & ZONING
Reviewed by:
� ��—
Date.
TREE ADMIN.
Second Review:
[]Approved as revised.
❑Denied.
PUBLIC WORKS
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by:
Date.
FIRE SERVICES
Third Review:
❑Approved as revised.
❑Denied.
Comments:
Reviewed by:
Date:
Revised 07/27/10
r -j A'111/1 . City of Atlantic Beach
�CtFl APPLICATION NUMBER
Building Department f eassi assigned b the Building Department.)
�.� 9 Y 9
800 Seminole Road
Atlantic Beach, Florida 32233-5445 JAN 09 Zp ���>C=L� �"y���-f
Phone (904) 247-5826 - Fax (904) 247-584
11
E-mail: building-dept@coab.us 8Y ate routed:
City web -site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:J 1 ( EGCj"R'T
Applicant:
Project
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:
[D]Approved.
Venied.
(Circle one.)
Comments:
BUILDING
PLANNING & ZONING
Reviewed by:
TREE ADMIN.
Second Review:
Approved as revised.
pp
[]Denied.
PUBLIC WORKS
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by
Date:
FIRE SERVICES
Third Review:
❑Approved as revised.
[]Denied.
Comments:
Reviewed by:
Date:
Revised 07/27/10
Revision Request/Correction to Comments
+" City of Atlantic Beach Building Department
si
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us
R vision to Issued Permit OR ❑ Corrections to Comments
Project Address:
Contractor/Contact Name:
**ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
PERMIT #: F-I--�CC l9 - oOO4
Date: Q - I r�)�` a
Contact Phone: `'1- lDl ��-1Email: EIVEM
-n EC
FEB 13 2019
11
cription of Proposed Revision / Corrections: 4 Y.
rm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• Will proposed revision/corrections add additional square footage to original submittal?
❑ No ❑ Yes (additional s.f. to be added: )
• Will proposed revision/corrections add additional increase in building value to original submittal?
❑No El *Yes (additional increase in building value: $ ) (contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
(Office Use Only)
Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due $
Revision/Plan Review Comments
j
_th -b"i C
Department Review Required: ° '" G"`""'
i din
ning & Zoning _) Reviewed By
ee A ministrator F E g 12 209
ctgis W
Public Utilities �� v
Public Safety "n
Dat
Fire Services W - Updated 10/17/18
MAP SHOWING SURVEY OF
LOT 5 & 6, BLOCK 205, TOGETHER WITH THE NORTH 1/2 OF WEST
PLAZA CLOSED BY ATLANTIC BEACH CITY ORDINANCE NO. 65-84-10,
ATLANTIC BEACH SECTION "H" AS RECORDED IN PLAT BOOK 18, PAGE
34, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
LOT 4
0
N
0
WEST PLAZA
ul N 50' RIGHT-OF-WAY (NOT OPEN)
CLOSED BY ATLANTIC BEACH
CITY ORDINANCE No. 65-84-10
Fouo 1/2' OW
WE to M7— —
ag�— • — —or ruin+ — S89'02I00-W 102.00'
NOTES: S88'33'J4'W 102.00' (FlELD)
1. THIS IS A BOUNDARY SURVEY.
2. NO BUILDING RESTRICTION LINES AS PER PLAT.
3. BEARINGS BASED ON THE WEST LINE OF THE
SURVEYED LANDS, BEING NORTH 01'16'00' WEST, AS
PER PLAT
p 10 zD 40
SCALE: 1' a 20'
LOT 4 d
roux aib ova+
O
r'p'E to Jy37 - -
N
LOT 5 Y
IN
kul
1811" J
to
N y LOT 6 m
RM arae
------- - -- -1------------
F E B 12 201;
THE PROPERTY SHOWN HEREON LIES IN FLOOD ZONE
"X" (AREA OF MINIMAL FLOOD HAZARD) AND FLOOD
ZONE "X" -SHADED (AREA OUTSIDE THE 0.27. ANNUAL
CHANCE FLOODPLAIN) AS WELL AS CAN BE DETERMINED
FROM THE FLOOD INSURANCE RATE MAP NUMBER
12031CO408J, REVISED NOVEMBER 02, 2018 FOR DUVAL
COUNTY, FLORIDA.
,w 9
THIS SURVEY WAS MADE FOR THE BENEFIT OF
DAN AND ELANA ROMANU'
Depart L a1C
/C'JjCCy G 11jr' 4 � _
_" •• fit ��if FL
L° y kk L.
'NOT VAUD WITHOUT THE SIGNATURE AND DONN W. BOATWRIGHT, P.S.M.
THE ORIGINAL RAISED SEAL OF A FLORIDA FLORIDA LIC. SURVEYOR and MAPPER No. LS 3295
LICENSED SURVEYOR AND MAPPER.' REV= eou+oMr. JNIUARY 31._=9 FLORIDA LIC. SURVEYING & MAPPING BUSINESS No. LB 3672
CHECKED BY. DATE
DRAWN BY: DAF BOATWRIGHT LAND SURVEYORS, INC. FEBRUARY 05. 2019
FILE 2019-0184 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET 1 OF 1
i
N89'1942 W 102.31' (FlELD)
N89'02'00'E 102.00'
DO
h �
Q
o
LLj0
C
---- 102.00'
/
\ Q)
to
LOT 6
ca
Q.
ut
I � �OOp
SOD IavF.IotiF � m
0
WEST PLAZA
ul N 50' RIGHT-OF-WAY (NOT OPEN)
CLOSED BY ATLANTIC BEACH
CITY ORDINANCE No. 65-84-10
Fouo 1/2' OW
WE to M7— —
ag�— • — —or ruin+ — S89'02I00-W 102.00'
NOTES: S88'33'J4'W 102.00' (FlELD)
1. THIS IS A BOUNDARY SURVEY.
2. NO BUILDING RESTRICTION LINES AS PER PLAT.
3. BEARINGS BASED ON THE WEST LINE OF THE
SURVEYED LANDS, BEING NORTH 01'16'00' WEST, AS
PER PLAT
p 10 zD 40
SCALE: 1' a 20'
LOT 4 d
roux aib ova+
O
r'p'E to Jy37 - -
N
LOT 5 Y
IN
kul
1811" J
to
N y LOT 6 m
RM arae
------- - -- -1------------
F E B 12 201;
THE PROPERTY SHOWN HEREON LIES IN FLOOD ZONE
"X" (AREA OF MINIMAL FLOOD HAZARD) AND FLOOD
ZONE "X" -SHADED (AREA OUTSIDE THE 0.27. ANNUAL
CHANCE FLOODPLAIN) AS WELL AS CAN BE DETERMINED
FROM THE FLOOD INSURANCE RATE MAP NUMBER
12031CO408J, REVISED NOVEMBER 02, 2018 FOR DUVAL
COUNTY, FLORIDA.
,w 9
THIS SURVEY WAS MADE FOR THE BENEFIT OF
DAN AND ELANA ROMANU'
Depart L a1C
/C'JjCCy G 11jr' 4 � _
_" •• fit ��if FL
L° y kk L.
'NOT VAUD WITHOUT THE SIGNATURE AND DONN W. BOATWRIGHT, P.S.M.
THE ORIGINAL RAISED SEAL OF A FLORIDA FLORIDA LIC. SURVEYOR and MAPPER No. LS 3295
LICENSED SURVEYOR AND MAPPER.' REV= eou+oMr. JNIUARY 31._=9 FLORIDA LIC. SURVEYING & MAPPING BUSINESS No. LB 3672
CHECKED BY. DATE
DRAWN BY: DAF BOATWRIGHT LAND SURVEYORS, INC. FEBRUARY 05. 2019
FILE 2019-0184 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET 1 OF 1
Date:
Permit #:
Review Status:
PUBLIC WORKS PLAN REVIEW COMMENTS
2/7/19
FNCE19-0004
DENIED
Applicant:
Email:
Mailing Address:
CITY OF ATLANTIC BEACH
Department of Public Works
1200 Sandpiper Lane
Atlantic Beach, FL 32233
(904) 247-5834
4vk 'M -lot ped
Elaina Romano
Not Provided
200 Trotter Road #426
Site Address: 1101 Begonia Street Weymouth, MA 02190
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:
• Provide a current, updated survey that includes the correct right-of-way infofmation.
APPROVED
PUBLIC WORKS CONDITIONS OF APPROVAL: A -f
(The following comments will be printed on your permit as Conditions of Approval)
• 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,
JDog/Dennis Junk Removal, All American Roll Off, WCA Waste Corporation). Container
cannot be placed on City right-of-way.
• Full right-of-way restoration, including sod, is required.
• All old fencing must be removed from job site by Contractor.
Scott Williams, Public Works Director swiIliams@coab.us / 904-247-5834
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 1 of 1
0:\Public Works\ADMIN\PLAN REVIEW COMMENTS\FNCE19-0004 (Owner-Romano).docx
;� MAP SHOWING SURVEY 0
LOT 5 & 6, BLOCK 205, TOGETHER WITH THE NORTH 1/2 OF WEST
I PLAZA CLOSED BY ATLANTIC BEACH CITY ORDINANCE NO. 5- 4-t0,
' ATLANTIC BEACH SECTION 'H" AS RECORDED IN PLAT BOO 16; PAGE
34, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUN , FL RIDA.
o $
V) 'rte
p �
,In;
3 o Q to 10 4A
o a O SCALE: r 20-
o LOT 4 I LOT 4
z I
cv �
NOTES: --j--------
1. TH15 IS A BOUNDARY SURVEY.
2 NO BUILDING RESTRICTION UNES AS FER PLAT.
3. BEARINGS BASED ON THE WEST UNE OF THE
SURVEYED LANDS, BEING NORTH 0116'00- WEST, AS
PER PLAT.
THE PROPERTY SHOWN HEREON LIES IN FLOOD 'AE'
HAVING A BASE FLOOD ELEVATION OF 5 FEET AND
FLOOD ZONE "X" (SHADED) AS WELL AS CAN BE
DETERMINED FROM THE FLOOD INSURANCE RATE
MAP NUMBER 12031CO408H, REVISED JUNE 3, 2013
FOR DUVAL COUNTY. FLORIDA.
THIS SURVEY
DAN AND Eli
MADE FOR THE BENEFIT OF
RO AND.
'NOT VALID VATHOUT THE SIGNATURE AND DONN W. BOA IGHT, P.S.M.
THE ORIGINAL RAISED SEAL OF A FLORIDA FLORIDA LIC. SU VOR and MAPPER No. LS 3295
LICENSED SURVEYOR AND MAPPER.' FLORIDA UC. SURVE NG � MAPPING BUSINESS No. LB 3672
CHECKED BY: DATE
Ci
DRAWN BY: DAF�j
BOATWRIGHT LAND SURVEYORS, I . NOVEMBER 23. 2016
FILE2016-1411 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 2411 8550 SHEET 1 OF 1
,
rarAvo r/t• �vav
aa'rAGrAr
r
s' wm rcr+rt N89'02'00"E 127.00 ar
Aar av
--------
W
a
C L/
`J
1
�
o
o
LOT 5 Y
I COT 5
Y
C)
-4-
U
V
CL
I
o-.
f i QW
VT
L0
I
.a
t]-•,j%�C
C3
O
I
G,1 ii )
Z
o
LOT 6 D 1
,f -c l
y h LOT 6
m
,—I
FLOOD ZONE "X" -SHADED
0
'
FLOOD ZON51—
t
- - - — -
- \
o
WEST PLAZA
N50'
RIGHT-OF-WAY (NOT OPEN)
I N
CLOSED BY ARAN T)C BEACH
sT In .ro+
CTTY ORDINANCE No. 65-84-10
Fll'M.Y) 1/1• MTI
7
u
— faar raw SB9'02'00'W 127.00'
S8842'38w 126.W' (FIELD)
i
NOTES: --j--------
1. TH15 IS A BOUNDARY SURVEY.
2 NO BUILDING RESTRICTION UNES AS FER PLAT.
3. BEARINGS BASED ON THE WEST UNE OF THE
SURVEYED LANDS, BEING NORTH 0116'00- WEST, AS
PER PLAT.
THE PROPERTY SHOWN HEREON LIES IN FLOOD 'AE'
HAVING A BASE FLOOD ELEVATION OF 5 FEET AND
FLOOD ZONE "X" (SHADED) AS WELL AS CAN BE
DETERMINED FROM THE FLOOD INSURANCE RATE
MAP NUMBER 12031CO408H, REVISED JUNE 3, 2013
FOR DUVAL COUNTY. FLORIDA.
THIS SURVEY
DAN AND Eli
MADE FOR THE BENEFIT OF
RO AND.
'NOT VALID VATHOUT THE SIGNATURE AND DONN W. BOA IGHT, P.S.M.
THE ORIGINAL RAISED SEAL OF A FLORIDA FLORIDA LIC. SU VOR and MAPPER No. LS 3295
LICENSED SURVEYOR AND MAPPER.' FLORIDA UC. SURVE NG � MAPPING BUSINESS No. LB 3672
CHECKED BY: DATE
Ci
DRAWN BY: DAF�j
BOATWRIGHT LAND SURVEYORS, I . NOVEMBER 23. 2016
FILE2016-1411 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 2411 8550 SHEET 1 OF 1
CD
Is
CARNATION ST
O
r
s
o w
A +, A
CO l f a
H _
N - W -
.-i J
O
O
co
,'- -p I
.
0 o a }
,i TULIP ST
-' f J; • urn
314
q •� 4 ,,, O b O o
p• yrs:. t'r 4i.sr I _ -+. �yy' ��I Rpr
,p^ _
•` Sll
ID
.w
w
`N N ay}N-,i f. N' v� 1, n O
O p; �. N Cn.i O �: O O O
OC) .... W . ► wi Cnr w . r,
_ 1
Co
oco
N N N N w
OOD 0
Co rjr'l
'"'� JASMINE Sl®z E�
JASMINE ST F�= V ° _ _ _ �D _
T '
>er ,D�i
�
_ _ �jj-,A��J J O .a • -a C4
�tr41'�Ip.. r 7. '~ O O O N A W `� 0,•��•,�K`�
00 CC W "krr oe�
+ z
j'j O'. '� O p.; - 60a 000 .1 r a Ni O _r 4 y O
OAF N O De =6 ik co p._, :p Q O iii y .;t...,K ar• O i'., D
CAMELIA ST
-8,r - _ ,. - o - s;�..-�;•� . _ _. _ - , " - - � -
CAMELIA S, �� 'j +�,: - w o w A w
TS
REVOCABLE ENCROACHMENT AGREEMENT
REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation
organized and existing under the laws of the State of Florida, hereinafter referred to as "CITY" and
0, K
referred to as "USER".
WITNESSETH:
of Atlantic Beach, Florida, hereinafter
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 nc t
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 USERh said notice to U ER shall be given by certified mail,
return receipt requested, to the following address Q(
• 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
here assum by the USER.
Property
in presence of Notary Public)
Date % — /?
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this day of, 720 ,
K
i C I R 0^.. a^ O , who personally appeared before me and
ed name o Signer)
e tha / e signed e i strument voluntarily for the purpose expressed in it.
7rN State o lorida
_ _ Department Approval:
Personally Known r!� ''? TOM GlN77ESPERGEIR
Produced Identification (Type) __ MY COMMISSION # FF 924951 t.
a -XpiiiEs!8eieber E, 2019
'6onced Thm No'ay a,ic Undeniri?ers �
W=--�colt I 1 ams, Pub is ork ire r
O:\Public Works\ADMIN\Revocable Encroachment Agreement.docx
Revision Date: 8/31/18
City of Atlantic Beach
Building Department
800 Seminole Road
�.9 Atlantic Beach, Florida 32233-5445
Phone (904) 247-5826 Fax (904) 247-5845
r ��rti,�;• E-mail: building-dept@coab.us
City web -site: http://www.coab.us
APPLICATION NUMBER
(To be assigned by the Building Department.)
on o4
Date routed:
APPLICATION REVIEW AND TRACKING FORM
Property Address: 10 ( Q_: I (�
Applicant: (,0 M C (. �
Project: FES
Review fee $
Department review required Yes No
uildin
anning & Zoning
Tree Administrator
ubis Wor
ic Utilit
ie
ic Safety
Fire Services
Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
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 RTATI PR
Reviewing Department
First Review:
[]Approved.
Denied.
(Circle one.)
Comments:
�I!✓� �C.Y1��e
�/�
Y���1�P
BUILDING
J
PLANNING &ZONING
Reviewed by:
/,),) DaterL/719
TREE ADMIN.
Second Review: ❑Approved as revised.
❑Deni d.
PUBLIC WORKS
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by:
Date:
FIRE SERVICES
Third Review:
❑Approved as revised.
❑Denied.
Comments:
Reviewed by:
Date:
Revised 07/27/10
ray -Jr, Revision Request/Correction to Comments
s" City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us
KjRvision to Issued Permit OR
Project Address:
❑ Corrections to Comments
Contra ctor/Conta((ctt Name: \ ) Q,
Contact Phone: ` 0A- LI V' ()QEmail:
ion of Proposed Revision / Corrections:
"ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
PERMIT#: F NCC ( 1 "Doi"
Date:—Q 1 I �'
I_L r-) I Q ( 6- i, V—A G nQJirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• Will proposed revision/corrections add additional square footage to original submittal?
❑ No ❑ Yes (additional s.f. to be added: )
• Will proposed revision/corrections add additional increase in building value to original submittal?
❑No ❑ *Yes (additional increase in building value: $ ) (Contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
(Office Use Only)
Ar'Approved ❑ Denied ❑ Not Applicable to Department
Revision/Plan Review Comme
Permit Fee Due
i- 'lig D; [ k - ✓n --To 6 Cu rx,.1 02-P v. S'
Department Review Required: -
P�Aministrator
,
&Zoning
Public Utilities
Public Safety
Fire Services
yr
FFR 1 2 2019 Reviewed By
;2 - W 'JLO/ 9
Date
Updated 10/17/18
Building Permit
City of Atlantic Beach Bu
r _ i 800 Seminole Road, Atla
Phone: (904) 247-5826 Ell
Job Address: //0 / tSy•'1b S,4
Legal Description -aS -aiF �d
Valuation of Work (Replacement Cost)
• Class of Work: 11 New ❑Addition ❑Alter]
• Use of existing/proposed structure(s): ❑(
• If an existing structure, is a fire sprinkler sys
I
• Will tree(s) be removed in association with t
Describe in detail the type of work to be performed.j;
Florida Product Approval #
Property Owner Information
Name A�_Aw;ALA )ec.-,q. u
City We*#i0Wf1N, A Stat
E -Mail
Owner or Agent (If Agent, Power of Attorney or Ager]
Contractor Information
Name of Company
Address
Office Phone
State Certification/Registration #
Architect Name & Phone #
Engineer's Name & Phone #
Workers Compensation Insurer
Application is hereby made to obtain a permit to do
commenced prior to the issuance of a permit and th
construction in this jurisdiction. I understand that a s
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANK
permit, there may be additional restrictions applicabl
there may be additional permits required from other)
federal agencies.
OWNER'S AFFIDAVIT: I certify that all the foregoing irl
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILUR11
RESULT IN YOUR PAYING TWICE FOR I
TO OBTAIN FINANCING, CONSULT WI'
RFCORDI_N(5 YOUR NICE OF COMMI
40'% (Signaturerof Owner or Agent)
Y,,r j.
igned and sworn to (or affirme
Tuan oN/7
- by
m3 _ZZ
200_3
36,
N 3 N C
O
N 0 A
o'
N L) m
['IJ Personally Known OR
y
N c) o
[ ] Produced Identification
a, oT
Type of Identification:
b
C, 1
J
plicotion
ing D partment
Beah, FL 32233
Bu Idin -Dent(
Al)u.4� Sec
L-y,^,l u'n,e_eo� C T
�oB COPY
Updated 10/9/18
"ALL INFORMATION
HIGHLIGHTED IN GRAY
COa .u5 IS REQUIRED.
Pe
OR
a�pair ❑Move ❑Dem
nerci❑Residential
insta4d?: ❑Yes [I Co
osed proiect? ❑Yes (must sub
Number: Fhe,E " D OCJr—�
G, ,4/!/1RE# / 710dd -1000
a r'i�'0S� - / • i0 /k 3�S
Non- Heated�Cooled
❑Pool ❑Window/Door
i
'3L' C,t o45. lore?6a
for nnultiple products use product approval form
Address o� /otti
Zip (' / 9p i hone
I
Letter Required) j
I Qualifying Agent
City
Job Site Contact Number _
E -Mail
OR Exen
work and installations as Indic
I work will be performed to m
rate permit must be secured t
nd AIR CONDITIONERS, etc. N
this property that may be fo
iernmental entities such as w;
accurate and that all
State Zip
: ❑ Expiration Date
?d. I certify that no work or installation has
L the standards of all the laws regulating
ELECTRICAL WORK, PLUMBING, SIGNS,
ICE: In addition to the requirements of this
J in the public records of this county, and
r management districts, state agencies, or
will be done in compliance with all
D RECORD A NOTICE F COMMENCEMENT MAY
PRO EMENTS TO YO RPROPERTY. IF YOU INTEND
YOU LENDER ORA ATTORNEY BEFORE
CEM NT.
(Signature of Contractor)
this day of Signed and sworn t or affirrtled) before me this day of
by i N.CIc gryi._/tr
(Signatu�ary)
[
Personally Known
[ ] Produced Identific�
Type of Identification:
° 3�
LL om
o ao
AGN
0
Y O w"
B�y�
�NEo
a ° E m
0
o'V T k
Z Z ::- W
rlvill;,y� City of Atlantic Beach
Building Department
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone (904) 247-5826 - Fax (904) 247-5845
E-mail: building-dept@coab.us
City web -site: http://www.coab.us
APPLICATION NUMBER
(To be assigned by the Building Department.)
c - 1 9y0o4
Date routed:
APPLICATION REVIEW AND TRACKING FORM
Property Address: _110i
Applicant: CD
Project: G (
Review fee $
p
ent review required Yes No
Zoningnistratorrtiesetyes
Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
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.
(Circle one.)
Comments
BUILDING
'
PLANNING & ZONING
Reviewed by:�/LeF_ ' Date:
TREE ADMIN.
Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by: �' Date:
FIRE SERVICES
Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
'Ni Alp Revision Request/Correction to Comments
City of Atlantic Beach Building Department
n
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us
CR vision to Issued Permit OR ❑ Corrections to Comments
Project Address:
Contractor/Conti
**ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
PERMIT #: FNCC. (9 - ow4
Date: a , I � ` I '
Contact Phone: gC11- LI 0' bu1�Email:
ption of Proposed Revision / Corrections:
firm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• Will proposed revision/corrections add additional square footage to original submittal?
❑ No ❑ Yes (additional s.f. to be added: )
• Will proposed revision/corrections add additional increase in building value to original submittal?
[]No []*Yes (additional increase in building value: $ ) (Contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
Approved ❑ Denied
Revision/Plan Review Comme
(Office Use Only)
❑ Not Applicable to Department Permit Fee Due $
Ir
Department Review Required: "-""' �'LJ
l din
Hing &Zoning > FEB 1 2 2019 Reviewed By
ee A ministrator
C;Zalc � 2- !S = If r -t
Public Utilities
Public Safety �,:. I "" Date
Fire Services = ' r.;=F , �� Updoted 10/17/18
PER PLAT. _----------
------------------------- FEB 12 201
THE PROPERTY SHOWN HEREON LIES IN FLOOD ZONE
"X" (AREA OF MINIMAL FLOOD HAZARD) AND FLOOD
ZONE "X" -SHADED (AREA OUTSIDE THE 0.27 ANNUAL
CHANCE FLOODPLAIN) AS WELL AS CAN BE DETERMINED
FROM THE FLOOD INSURANCE RATE MAP NUMBER
12031CO408J, REVISED NOVEMBER 02, 2018 FOR DUVAL
COUNTY, FLORIDA.
THIS SURVEY WAS MADE FOR THE BENEFIT OF
DAN AND ELANA ROMAND-Lifftdfng Dep
"NOT VALID WITHOUT THE SIGNATURE AND DONN W. BOATWRIGHT, P.S.M.
THE ORIGINAL RAISED SEAL OF A FLORIDA FLORIDA IJC. SURVEYOR and MAPPER No. LS 3295
LICENSED SURVEYOR AND MAPPER." FLORIDA LIC. SURVEYING & MAPPING BUSINESS No. LB 3672
RMSM MMMr. JAWMY M 4079
CHECKED BY: DATE-
DRAW
ATEDRAWN BY: DAF BOATMIGHT LAND SURVEYORS, INC. FEBRUARY 05, 2019
FILE 2019-0184 11 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET 1 OF 1
I
V
9 �
FmwJ/rim
MAP SHOWING SURVEY
OF
RMNO CAP
�
LOT 5 & 6, BLOCK 205, TOGETHER WITH THE NORTH 1/2 OF WEST
PLAZA CLOSED BY ATLANTIC BEACH CITY ORDINANCE
NO. 65-84-10,
ATLANTIC BEACH SECTION "H" AS RECORDED IN PLAT BOOK 18, PAGE
34, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY,
FLORIDA.
09
oX
Lc)
N
I3w
� O 3
'o
O
Q
10 ZO 40
ami
I
SCALE: 1" a 20'
o P
7 2 2
LOT 4
i LOT 4
I
N
i
N89'19'421W 102.31' (FIELD)
N89"02'00'E 102.00'"°
7
7
0
_ —
N
kL
�y}L
o\�
1 ''LOT 51_
LOT 5
Q
SLI a
b --
� ----102.00----------
009
9•-
\
�Li
r O
LOT 6 J
N LOT 6
W U
L
a
�
Q.
_G
000 �. ?ONF 22
ON X"
WEST PLAZA
0
o
50 RIGHT-OF-WAY (NOT OPEN)
n
N
CLOSED BY A7LAN77C BEACH
o J�
Cl TY ORDINANCE No. 65-84-10
mm "m
FFE LB JW
ma + $89*02'00"YV 102.00'
NOTES:
ae
S88'33'34'W 102.00' (FIELD)
yy!
1. THIS IS A
BOUNDARY SURVEY.
2. NO BUILDING
RESTRICTION LINES AS PER PLAT.
3. BEARINGS
BASED ON THE WEST LINE OF THE
SURVEYED LANDS, BEING NORTH 01'16'00" WEST, AS
PER PLAT. _----------
------------------------- FEB 12 201
THE PROPERTY SHOWN HEREON LIES IN FLOOD ZONE
"X" (AREA OF MINIMAL FLOOD HAZARD) AND FLOOD
ZONE "X" -SHADED (AREA OUTSIDE THE 0.27 ANNUAL
CHANCE FLOODPLAIN) AS WELL AS CAN BE DETERMINED
FROM THE FLOOD INSURANCE RATE MAP NUMBER
12031CO408J, REVISED NOVEMBER 02, 2018 FOR DUVAL
COUNTY, FLORIDA.
THIS SURVEY WAS MADE FOR THE BENEFIT OF
DAN AND ELANA ROMAND-Lifftdfng Dep
"NOT VALID WITHOUT THE SIGNATURE AND DONN W. BOATWRIGHT, P.S.M.
THE ORIGINAL RAISED SEAL OF A FLORIDA FLORIDA IJC. SURVEYOR and MAPPER No. LS 3295
LICENSED SURVEYOR AND MAPPER." FLORIDA LIC. SURVEYING & MAPPING BUSINESS No. LB 3672
RMSM MMMr. JAWMY M 4079
CHECKED BY: DATE-
DRAW
ATEDRAWN BY: DAF BOATMIGHT LAND SURVEYORS, INC. FEBRUARY 05, 2019
FILE 2019-0184 11 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET 1 OF 1
I
V
9 �
Fmw JAram MAP SHOWING SURVEYR04 10 c� D
LOT 5 k 6, BLOCK 205, TOGETHER WITH THE NORTH 1/2
1 PLAZA CLOSED BY ATLANTIC BEACH CITY ORDINANCE NO.
ATLANTIC BEACH SECTION 'H" AS RECORDED IN PLAT BOO
34, OF THE CURRENT PUBLIC RECORDS OF DUVAL COU
OFJWEST
5 -
18'
4 -10,
RIDA.
o�
1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 24SHEET
1. THIS IS A BOUNDARY SURVEY.
h� V)
U
2. NO BUILDING RESTRICTION LINES AS PER PIAT
N
3. BEARINGS BASED ON THE NEST LINE OF THE
30
h
L03
SURVEYED LANDS, BEING NORTH 0196'00' WES AS
O
S M14DE FOR THE BENEFIT OF
PER PLAT'
rry
RO�ANO.
LOT 4
2
z1
z N
HAVING A BASE FLOOD ELEVATION OF 5 FEET AND
'F
O
O �
I
Q r0 Nor u'4" °-a2' 6• mom Fz N89'02'00'E 12 00' °
O rw� u°r LcwLc -
W
3 o L 5
Q I n
I �
O - — - - 127.00'
o I
W) I
[� L7 raiA
Z c LU 6 D' ClIJ
FLOOD ZONE X" -SHADED
10 \ m
FLOOD ZON 5t—` —
WES PLAZA
N 5 '
RIG) -WAY (NOT OPEN)
L f ATLANTIC BEACH
C1 D ANCE No. 65-84-10
�0'ja'W 126.93' F1ELP) ,
SCALE: 1 - 20'
I L T 4
1
I
rALLIN- OV
/C4
/
LOT 5
�-----------
I
FILE
1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 24SHEET
1. THIS IS A BOUNDARY SURVEY.
1 OF 1
U
2. NO BUILDING RESTRICTION LINES AS PER PIAT
3. BEARINGS BASED ON THE NEST LINE OF THE
SURVEYED LANDS, BEING NORTH 0196'00' WES AS
THIS SURVEY W
S M14DE FOR THE BENEFIT OF
PER PLAT'
LW w
RO�ANO.
C3
z1
HAVING A BASE FLOOD ELEVATION OF 5 FEET AND
'F
h
FLOOD ZONE "X" (SHADED) AS WELL AS CAN BE
N 51 LOT 6
m
SEF F/7- WIN
rw[ u m"
CHECKE=BY'
DRAWN
-
�-----------
NOTES: _-__--_�-_____--
--j --
FILE
1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 24SHEET
1. THIS IS A BOUNDARY SURVEY.
1 OF 1
2. NO BUILDING RESTRICTION LINES AS PER PIAT
3. BEARINGS BASED ON THE NEST LINE OF THE
SURVEYED LANDS, BEING NORTH 0196'00' WES AS
THIS SURVEY W
S M14DE FOR THE BENEFIT OF
PER PLAT'
DAN AND ELAN
RO�ANO.
THE PROPERTY SHOWN HEREON LIES IN FLOOD 'AE"
HAVING A BASE FLOOD ELEVATION OF 5 FEET AND
FLOOD ZONE "X" (SHADED) AS WELL AS CAN BE
DETERMINED FROM THE FLOOD INSURANCE RATE
MAP NUMBER 12031CO408H, REVISED JUNE 3, 2013
FOR DUVAL COUNTY, FLORIDA.
'NOT VALID WITHOUT THE SIGNATURE AND
DONN W. BOA
IGHT, P.S.M.
THE ORIGINAL RAISED SEAL OF A FLORIDA
FLORIDA UC. SU
VE*M and MAPPER No. LS 3295
LICENSED SURVEYOR AND MAPPER.'
FLORIDA UC. SURVE
NO t MAPPING BUSINESS Na LH 3672
CHECKE=BY'
DRAWN
'RIGHT LAND SURVEYORS, I�"GJ
C.NOVEMBER
DATE -
23. 2016
FILE
1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 24SHEET
1 OF 1