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366 Plaza DWAY19-0010 Replace curb & sidewalk ,0_,Apif{„ DRIVEWAY PERMIT PERMIT NUMBER S' CITY OF ATLANTIC BEACH DWAY19-0010 )Y,_ Y800 SEMINOLE ROAD ISSUED: 3/19/2019 r— °'i"" ATLANTIC BEACH. FL 32233 EXPIRES: 9/15/2019 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: DRIVEWAY SINGLE OR TWO 366 PLAZA FAMILY DRIVEWAY replace curb & sidewalk $0.00 TYPE OF ! REAL ESTATE BUILDING USE CONSTRUCTION: j NUMBER: ZONING: GROUP: SUBDIVISION: 169973 0000 ATLANTIC BEACH COMPANY: I ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ' ZIP: FOGG MICHAEL L 366 PLAZA ATLANTIC BEACH FL 32233-5442 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 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. 2 PUBLIC UTILITIES METER BOX SEWER CLEAN OUT INFORMATIONAL Notes: Ensure all meter boxes,sewer cleanouts and valve covers are set to grade and visible. Issued Date: 3/19/2019 1 of 2 DRIVEWAY PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH DWAY19-0010 800 SEMINOLE ROAD ISSUED: 3/19/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 9/15/2019 3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. 4 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL Notes: Sidewalk cannot be left open more than 24 hours. 5 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL Notes: A standard Miami curb and a flat sidewalk is required. See attached Specifications. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT • • PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.001 TOTAL: $25.00 Issued Date:3/19/2019 2 of 2 rSy�•f� City of Atlantic Beach APPLICATION NUMBER 11- `'(•:>a Building Department (To be assigned by the Building Department.) it 800 Seminole Road (� l' /� _ 7� u._ r� Atlantic Beach, Florida 32233-5445 `Nitv A l Vt 00( LJ Phone(904)247-5826• Fax(904)247-5845 tij1 E-mail: building-dept@coab.us Date routed: 3 114. City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: (J ( a- Department review required Yes No Building Applicant: Ow' k Planning &Zoning _Administrator Project: c L 4Mu b W,UL� �,�..;, 1 Public Utilities Pu• is Safety Fire Services Review fee $ Dept Signature Review or Receipt Other Agency Review or Permit Required 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. I INot applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by. Date: � 41°." TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑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 j,.1,`J;:? City of Atlantic Beach APPLICATION NUMBER v1 4017Building Department (To be assigned by the Building Department.) 800 Seminole Road I {� `' /� 0 � Atlantic Beach, Florida 32233-5445 4V l` l �"l 001 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: 3 I Ie)- t I� City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ( 1 t� �) Department review required Yes No Building Applicant: O )N12—f Planning &Zoning • ree Administrator Project: cL Mau__ tu-1 b atii.) AL Public Utili ies 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: APPLI ION STATUS Reviewing Department First Review: Approved. Denied. fNot applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: � . e: 3--/3--f9 TREE ADMIN. Second Review: 'Approved as revise . ❑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 PUBLIC UTILITIES PLAN REVIEW COMMENTS Date: 3 I61 1 9 Application#: W (I' —00 10 Project Address: 3(Q Check Box Check APPLICATION TRACKING COMMENTS to Add Box to Comment; Print Underground Avoid damage to underground water and sewer utilities. Verify vertical and Water Sewer horizontal location of utilities. Hand dig if necessary. If field coordination is 0 Utilities needed, call 247-5878. Meter Boxes Ensure all meter boxes, sewer cleanouts and valve covers are set to grade Sewer Cleanout and visible. 0 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 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 ❑ ❑ Meter must be tested by a certified tester and a copy of the results sent to Public Utilities. Fire Sprinkler If fire sprinkler system is provided,call 247-5878 for backflow requirements. Backflow At a minimum,will require a double check backflow preventer. 0 ❑ Requirement 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 0 Disconnect &Cap Disconnect and cap water and sewer lines. 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 ❑ 0 O ❑ .,-t F RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION **ALL INFORMATION .} 144 1 City of Atlantic Beach HIGHLIGHTED IN GRAY IS I .. 800 Seminole Road, Atlantic Beach, FL 32233 REQUIRED. PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES Job Address 6- PL,A Z.,4 Permit Number 43 k) Al I ei - X (? Contractor Information 6.CTAr-- Company Company 414 F v (.V/P'.0— Qualifying Agent f C46'--t/ 76.c.,-- Address ddress 36.6 - ZA City k--- State 1L Zip 3 ZZ.33 Phone 1 b cf-- 2 3 SSg3 Email ("A --C I-6�,. ......-,..-1--z,....,-4-1„, �4- State Certification/Registration # J Architect Phone Email Engineer Phone Email Workers Compensation Insurer OR Exempt rikrijpiration Date • Permittee declares that prior to filing this application they have ascertained the location of all existing utilities,both aerial and underground and the accurate locations are shown on the sketches. • Whenever necessary for the construction, repair,improvement, maintenance,safe and efficient operation,alteration or relocation of all,or any portion of said street or easement as determined by the Public Works Director,any or all said poles, wires,pipes,cables or other facilities and appurtenances authorized hereunder,shall be immediately removed from said street or easement or reset or relocated hereon as required by the Public Works Director and at the expense of the Permittee unless reimbursement is authorized. • All work shall meet City of Atl ntic Be ch or Florida De rtment of Transportation Standards and be performed under the supervision ofC C �� (Project Superintendent) with (Company Name) Phone • All materials and equipment shall be subject to inspection by the Public Works Director. • All city property shall be restored to its original condition as far as practical,in keeping with City specifications and the manner satisfactory to the City. • A sketch of plans covering details of this installation,as well as a copy of a recent survey shall be made a part of this permit. Calculations showing any increase in impervious area on owner's lot or in the City right-of-way are to be included with this application. • The permittee shall commence actual construction in good faith within days. If the beginning date is more than 60 days from date of permit approval then permittee must review the permit with the Public Works Director to make sure no changes have occurred in the area that would affect the permitted construction. • It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder,and the holder will,at all times,assume all risk of and indemnify, defend and save harmless the City of Atlantic Beach from and against any and all loss, damage and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. • The Public Wor, ;' -ctor shall be notified 24 hours prior to starting work and again immediately upon co pletio . C � C—, _ 3/ /( �� Date7 Permittee(signed in presence of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL I The foregoing instrument was acknowledged this _ ) day of a\.Q • C ,20 ! , by 14 � ,who personally appeared before me and (printed name of P:rmittee) _� ...... TONI GINDLESPERGER acknowl•.::d that he/. igne*the instrum:nt voluntarily for the purpose expressed in it. MY COMMISSION#FF 924951 EXrIRES:October 6,2019 ` Bonded Thru Notary Public Onderxnters �– .L_ . [ 1 Personally K own \ f Signature of Notary Publi , .te o FloridaIII [ ] Produced Identification(Type) L, l� H:\Applications&Forms\Word&Excel Document Originals\2i 801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18 t' = ,; Owner Builder Affidavit **ALL INFORMATION HIGHLIGHTED IN 'y City of Atlantic Beach Building Department GRAY IS REQUIRED. Allir ' 800 Seminole Rd, Atlantic Beach, FL 32233 /� A nt ' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: Ow Ai 1q'OOtO 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. 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: .34:6 ��- Zi4 7/C�Ji 4 �Z B, . --4 3� 3 Owner Name: �/ ! (`(G1.z/ ;j _ Phone Number: 90 V Z 3 .�s 93 Mailing Address: City: ---S—~1-e. State: Z Zip: Notarized Signature of Off- t._.. Theoing instr ment was acknowledged before me this day of '1 .t. 2019n the State of Florida, County of 0 fc�� 1,.___c_ ,C Signature of Notary Publ [ ] Personally Known OR [ ] Produced Identification T., Type of Identification: F Z 0C E>U Z - S2-2Z8 - - <<4;;bye, TONT GNDLESPERGER `,�, '4= MY COMMISSION#FF 924951 Updated 10/24/18 •• ; EXPIRES:October 6,2019 "'• 0, Bonded Thru NotaryPubiic Underwrters * REFER TO TABLE FOR PAVEMENT SECTION THICKNESS CURB . SEE PLAN ASPHALT (FDOT TYPE S-3) 6" 1_ LIMEROCK BASE 3"R 6" 2 SLOPE PER PLAN I�>e // 2" )c )!' �� i �r� ZW ,, v im::: :6 ° ° .'-)14-7- vAteAtosiLe4bliata .: ,: , aP 4IP- ',,-- ' '',! 7 6" 7"% L PUBLIC WORKS APPROV D { } DENIED { } N ST APPLICABLE TO DEP AI/ 4./; f _ SAME SLOPE AS n s E ADJACENT PAVEMENT �..— / 5" F--- -4"R " „ 1 8 10" I 1 R. 10 " R I „ R. DROP Ry-i" h" R. 4` k T 1/2"R T p 0 s f a 1 a 1--.--18" -I 18„ �. I- 18"---------.4DROP CURB MIAMI CURB MEDIAN CURB 1/8" /2�, APPROVED SEALER 1/8" _ 1/4" –4-- 0 1/4"R Q a o a a o - --- Lti -1-21FD/47 CONTROL JOINT CONTRACTION JOINT JOINT SEALER--N I 11. P.^ ^^•^ 1. PROVIDE TRANSVERSE EXI ,.,n k IAV CDA(`U Michael Fogg 366 Plaza, AB 32233 5-69 16-2S-29E ATLANTIC BEACH LOT 31 BLK 10 (904) 234-5593 Design for replacing city's Crumbling Curb and Bowed sidewalk. (As per meeting with Scott Williams, Director of Public Works, 2/26/19) Existing Existing Driveway Driveway <Sidewalk <Curb 17' 6„ 16' = Areas to be replaced 6 10" Curb Detail ' b � �--- Expansion Joint 181( .�^�,