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1772 SEA OATS DR DWAY19-0006 DRWY PERM DRIVEWAY PERMIT PERMIT NUMBER DWAY19-0006 CITY OF ATLANTIC BEACH ISSUED: 3/12/2019 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 EXPIRES: 9/8/2019 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: 1772 SEA OATS DR DRIVEWAY SINGLE OR TWO DRIVEWAY AND WALK WAY $9000.00 FAMILY DRIVEWAY TYPE OF REALESTATE BUILDING USE ZONING: SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 1720200426 SELVA MARINA U NIT 08 COMPANY: ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ZIP: SHERRILL PETER G 1772 SEA OATS DR ATLANTIC BEACH FL 32233-5829 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. EROSION CONTROL INSTALLATION INFORMATIONAL PUBLIC WORKS 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: 3/12/2019 1 of 2 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road ID uu t9 -0 00 Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: Z 9 City web-site: http://vvww.coab.us 11 APPLICATION REVIEW AND TRACKING FORM Property Address: 1-7 7 Z_ c—a C'Da—cs Department review required Yes No Buil�m Applicant: CfFanning Tree72­m­[ri`isTr.1t6r Project: _P,�olu_ tg�fficWor�ks PubRc�fi i ies Lk� Puv,uo 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. E]Denied. E]Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: ei�� A-11 Date:,01 TREE ADMIN. Second Review: E]Approved as revised. E]Denied. E]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. F]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 ri ID L�j A��4, t9 -o rn z Atlantic Beach, Florida 32233-5 Phone(904)247-5826 - Fax(9 �t;24f%& 4 2019 r;I J!)� E-mail: building-dept@coab.uE Date routed: Z Cityweb-site: hftp://www.coab. V APPLICATION REVIEW AND TRACKING FORM Property Address: Department review required Yes No Builcl�g__ Applicant: ("3&4z� (�anning &Zon6_9__, Tree A_d_ffiFn_i§tMt(5r Project: pomu_ P—kjp-") NL,/ _eUgEc�Works IL Public tilifies L�� PL-V,Lo 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: VA-'pproved. ElDenied. E]Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed Date--- TREE ADMIN. Second Review: [—]Approved as revised. ElDenied. E]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: [—]Approved as revised. F]Denied. E]Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 Building Permit Application Updated 10/9/18 City of Atlantic Beach Building Department "ALL INFORMATION 800 Seminole Road, Atlantic Beach, FIL 32233 HIGHLIGHTED IN GRAY 7 Phone: (904) 247-5826 Fax: (904) 247-5845 Email: Build ing-Dept@coab.us IS REQUIRED. Job Address: 7 Z_ _5�� 67,41-� /V.Z— 1�1' 14 4_Vr in 4`N u rn b e r: DW Legal Description RE# Valuation of Work(Replacement Cost)$ Heated/Cooled SF Non-Heated/Cooled ClassofWork: eNew DAddition ElAlteration ORepair ElMove E]Demo E]Pool E]Window/Door Use of existing/proposed structure(s):10commercial [3Resiclential If an existing structure, is a fire sprinkler system installed?:FRIYes &o Will tree(s) be removed in association with or000sed ProiectAkes(must submit seaarate Tree Removal Permit) 04-0---- Describe in detail the type of work to be performed: , L-44-//C—4)--1 " 1"' 1-,4—e Florida Product Approval# for multiple products use product approval form Property Owner Information N am e- /7/�4-z2 4 Z Y1117—r1_11 Address VZ_ city Z State zip 7z Z7 �H,_Lr_ 4yzz-�/,/- Phone 2 -7-/- 8- 5-e E-Mail ,el i/ , Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) n/a 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 Insurer OR Exempt Ei 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 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 Rk,�Cp D111,Nt)=UOTICE OF 0 MMENCEMENT. (Signature of Owner or Agent) (Signature of Contractor) Signed and sworn to(or affirmed) before me this'74kday of Signed and sworn to(or affirmed) before me this day of (11),n 1 by A�-_J�t-A(V I U U.� _r") by (Signature of Notary) .4 NNERS �V I S W R Ar�l W COMWSSION#G 123203 dL MIT -1 y 0 1 EXPIRES:July 114�.20211 �ipersonally Known OR BMW Ttft Personally Known OR [ ]Produced identificat Produced Identification Tvoe of identification: Type of Identification: Owner Builder Affidavit "ALL INFORMATION HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 1. 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. YOUHAVEAPPLIED 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. 11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. . Ill. 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(l). 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. CONTACT THE BUILDING DEPARTMENT(904- 247-5826 OR BUILDING-DEPT@COAB.US ) 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. Job Address: 1772 Sea Oats Drive Owner Name:Margaret Sherrill Phone Number: 904-962-4041 Mailing Address: 1772 Sea Oats Drive City: Atlantic Beach State: fl Zip: 32233 A Notarized Signature of Owner IL/I A oreg ing i _O)Cdayof 20 County Th f nstrument was acknowledged before me this in the State of Florida, of Signature of Notary Public /uh, —4 4ersonally Known OR Produced Ide-itifi-rn±' 'NNERSD" LAVONDA J,CONNERS GG myCoMwSSION OGG 123203 4A M71 Type of Identification: i EXPIRES* Bonded Th(u NOWY Pubk W160MID""s Updated 10124118 ORDERED BY HILLEREST lerec I L 322 11 PROPERTY ADDRESS: 1772 SEA OATS DRIVE ATLANTIC BEACH,FLORIDA 32233 SURVEY NUAR:FL1412.2385 FIELDWORK DATE:1212212014 REVISION DATEM:(REv.o i2r"2D14) Jr- FL14122M BOUNNRYSURVEY 110 DWAL COWTY LOT 14 LOT 9 BILK 14 30. 5LK 14 o 5G'I 5-If I 22.138'(M) FIF, N 87* 87157-45-E 123.28'(F) NO ID No ID NE W f/e- 30.1' �Okr !:7 w di LOT 15 BILK 14 LOT a b 5LK 14 E4 N 01 gig 15TY RES&1-172 In Lb 49.3' 32.V— OAY, 36' Fir - 5 67*19'3 1 W 125-G3'ff) NO ID r p 5 87*18'3 W I 23.99'(M) iA No 10 0 1.5'WIC E. Cz) LOT 7 LOT G NO ID BILK 14 NOTES: BLK 4 a F.C. SrrBACK INrOKMATION SHOWN ON FLAT.NOT VERIFIED LOT A"M5 TO BE 5EFMCrD BY CITY WATM AND SEWER TA2BILE: M%a OWNERSHIF NOT DETERMINED LI NOW'20PE21.10(F) N CIV810 11 E 2 1.1 11(M) STE, SE 1herebyce oun ey of Me hereon described p rtyhas made or my direction, and to the s ofmykno d a fief,It is a true and arcura VO ti that meets the minimum to /stbnda� s set to Me Florida Boaro 30 0 15 30 ofProfe ona rvoy�j"44ap n Chapter 5J-17 of th,�Flon:Ad 11 s uRv'Io GRAPHIC SCALE (In Feet) I inch = 30' ft. KEITH A.STEPHENSON 3mborpa PmbNIo'wIswvq/NvWMePW Lkwm No.6521 U. ffh.�S—ey I.,P.r,--.1he,lh-1—ded,wthout wntten Verification,m1i he at the U—,Sol,Ri,k,,d Wah—Oabdily to the surYeyot N,th,,g h,r,,n,h,li�C—t�to G—ANY R,ght, 8—M,1.Ar,,o—O'he,Ih..th—Cenofi� FLOOD INFORMATION: OF INTEREST BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING VISIBLE MUNICIPALITY OR WWW.FEMA.GOV,THE PROPERTY APPEARS TO BE LOCATED IN ZONE X.THIS PROPERTY WAS FOUND IN THE CITY OF ATLANTIC BEACH,COMMUNITY NUMBER 120075,DATED 0&W13. CLIENT NUMBER:HC144)067 DATE:12/30/201 AFFILIATE MEMBERS BUYER:PETER AND MARGARET SHERRILL SELLER: AND TRUST;OLD REPUBLIC NATIONAL TITLE CERTIFIED TO:PETER AND MARGARET SHERRILL,HILLCREST TITLE �ACTkk INSURANCE COMPANY;JAX FEDERAL CREDIT UNION EK Land Surveyors, Inc. —86SI 7 U-2,8 8-2 This is page 1 of 2 and is not valid without all pages. L6#7337 1 1940 F a—Y Lake�D—,SlIne I-Ft.MyeM FIL 33913 REVOCABLE ENCROACHMENT AGREEMENT City of Atlantic Beach "ALL INFORMATION HIGHLIGHTED IN GRAY 800 Seminole Road,Atlantic Beach,FIL 32233 IS REQUIRED. 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 Margaret Sherrill 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 Replace existing driveway with brick pavres Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty(30)days'notice by CITY to USER,said notice to USER shall be given by certified mail,return receipt requested,to the following address 1772 Sea Oats Drive Atlantic Beach FL 32233 • 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 hereby assumed by the USER. Date Property Owner/Agent(signed in presence of Notary Public) STATE OF FLORIDA, COUNTY OF DUVAL The foregoing instrument was acknowledged this day of FrL4,ri 3 20 by c, r(A- �C T— who personally appeared before me and (printe"ame of Signeri acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. MARLABUCHANAN State of Florida Notary Public Department Approval: Commission#GG 1693 11 Sig!�dture of Notary Public,State"ofFlorida My Comm.Expires Dec 19.202 Bonded through Nationa'Noary Ass^ Upersonally Known W W W 0 - - - )4-1.-X-4a [ ] Produced Identification(Type) Sco�?Z�i(Ka;Ws, P­ub-4-c'WdLrk'rn'T1r`ector H:\Applications&Forms\Word Documents\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18