1989 Brista Del Mar Cr. DWAY18-0040 Replace concrete with pavers DRIVEWAY PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH DWAY18-0040
9 ISSUED:800 SEMINOLE ROAD 3/19/2019
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:
1989 BRISTA DE MAR CIR DRIVEWAY SINGLE OR TWO REPLACE CONCRETE DRIVE $6576.00
FAMILY DRIVEWAY WITH PAVERS
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169506 1678 SELVA NORTE UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
ANDERSON PAVERS INC 1244 ARROWLEAF TER JACKSONVILLE FL 32225
OWNER: ADDRESS: CITY: STATE: ZIP:
BROMMER BRUCE A 1989 BRISTA DE MAR CIR ATLANTIC BEACH FL 32233-4525
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:3/19/2019 1 of 2
r '- ''r DRIVEWAY PERMIT PERMIT NUMBER
�'� ' j� �s'` DWAY18-0040
Ir. CITY OF ATLANTIC BEACH�r ISSUED: 3/19/2019
� 800 SEMINOLE ROAD
';;,':�"" ATLANTIC BEACH. FL 32233 EXPIRES: 9/15/2019
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,JDog/Dennis Junk Removal). 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 RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
6 PUBLIC WORKS MAXIMUM DRIVEWAY INFORMATIONAL
Notes:
Maximum driveway width within the City right-of-way is 20 feet.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $50.00
TOTAL: $75.00
Issued Date:3/19/2019 2 of 2
i'ty,1`.1: City of Atlantic Beach APPLICATION NUMBERs Building Department (To be assigned by the Building Department.)
'' '� 800 Seminole Road 1 . ' n 1� ( /�
A _, Atlantic Beach, Florida 32233-5445 O W P !I U —VC)4 0
t)
Phone(904)247-5826 • Fax(904)247-5845'!'!o, � Email: building dept@coab.us Date routed: I z 1 Z (1, CD _
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
CAR._
Property Address: 1 ` C ,9 e-,R,s-TA_ L6fr., __ Department review required Yes No
Buildiria_
Applicant: , L so L r
` _ ! (Planning &Zonings
110 T eAdminisrraator
Project: i .AVE-12 n p.,,(v- j ublic Works
Public Utiitl 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:
APPLICATION STATUS
Reviewing Department First Review: ❑Approved. I (Denied. Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:/€-- 0,4X----- Date: ( 2. -1I-1$
TREE ADMIN. Second Review: Approved as revised. Denied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: I 'Approved as revised. ['Denied. Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
r (Tool. Lyr ��V
ic City of Atlantic Beach APPLICATION NUMBER
r s '�Apor , Building Department
be assigned by the Building Department.)
Q 800 Seminole Road DW C 8 _V/,0 4 0
:4. Atlantic Beach, Florida 32233-5445A DEC 12 2018
Phone(904)247-5826 • Fax(904)2 5845 `,
,:v J E-mail: building-dept@coab.us Icy:_Y Date routed: Z Z L
City web-site: http://www.coab.us --
APPLICATION REVIEW AND TRACKING FORM
lo-
Property Address: ICI 59 R157{}- D E inct 2_, Department review required Yes No
Buildna
Applicant: &c.),..) 3 Vr-.� Planning &Zoning
Tree dminis ra or
Project: A V& p ial\feuo.A- ublic Work
Public Utilities
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. I (Denied. Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: 7 -Ari/
TREE ADMIN.
Second Review: ['Approved as revised. Denied. I Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. I 'Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
MAP SHOWING SURVEY OF
LOT 94, SELVA NORTE ' UNIT TWO, AS RECORDED IN PLAT BOOK 40 , PAGES 37 AND
37A OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
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Building Permit Application Updated 10/9/18
Pr*
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� City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
\<-tin Phone: (904) 247-5826 Fax: (904) 247-5845 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: qv-t \e- cc\parUkYat_ Permit Number: U rV R'y� 004(.J
Legal Description RE#
Valuation of Work(Replacement Cost)$ Lp5'14 oD Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration $(tepair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial pesidential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes ❑No EN/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: '91exv c0,e., C'XAsk(net �r\VQ-031
�•���ce.. 1w� . �D f�CAre e. cis - S alf"ve. O4& -et A s•\,}
Florida Product Approval# _ for multiple products use product approval form
Property Owner Information m
Name C,��. �� r�L 8a. grot+nnv� Address ICI In �t-� �a. \ `COh
City - -i: � l State' Zip 3p.a. 3 Phone 90�•alq-
E-MaiI 4b"rove.% ck+ eileQtM.. ,rvet
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company
'1 �Y -`QAcsc�tN. 4o..L. n Qualifying Agent -..06. i\ err‘.
tSC-r
Address �a.�'& r'rO Otto. 'T•exx-0,4 City"S.r -c ;1\. State��'\ Zip 32 Aas-
Office Phone 9 b xsq-as 93 Job Site Contact Number Qot1• 2..S.4—a-51
State Certification/Registration# Q 50000 gagla E-Mail 44"..612ot% 'cla.cKrrqIcgtr�p.ak.c. �
Architect Name& Phone# J
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt% Expiration Date 00.1/,,p/g
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 OB .. N FINA CING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
REC''R.ING R NOTICE OF COMMENCEMENT.
/_ Com, �3u 424.44,
(Signature of Owner or A nt) (� (Signature of Contractor)
Signed an sworn to(or affirmed) before me this U day of Sign d and sworn to(or affirmed) before me this J d ya of
DeC C11/19e/ l 8 , • • C C g ram nl e r C,�Vi �+�� . 0►2 „z Ol e,by / CLri_ a ,'-"tart--
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• 0%, MYCOMMISSI 22 of NO i ry) JESSIC - • , • star'
:.; id., :.; " 7F 118145 ,..
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-::-F`,.• EXPIRES:June 12,120 ;' _ SION#GG •8436
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Bonded hru Notary u '.;�'; ��` EXPI ES:December 14 021 '
Public nderwAterr ,.�° ,
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( Produced Identificatio ( :•seed Identification
Type of Identification: 5 r'V( t I G(145 C• Type of Identification:
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. NE.g a LE./ B raw. �.e&�.e.a�I- of Atlantic Beach, Florida, hereinafter
referred to>�s"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 (�,e,Q�, Lp ke 14%;utWo.e .
Any facility maintained, repaired, erected, and/or installed in the exercise of the'privilege gra ted 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 1e{agCt &Atka,I •elv1ave .
• 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
treby as • sy the USER.
- • Date /2./ Zo,
P operty Owner/Agent(signed in preselice of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL Q
The foregoing instrument was acknowledged this O day of DeC e tli 6 e r ,20 I 8 ,
by gtUC:e. Gerromm e C, Cyr ` mCbfRe- ,who personally appeared before me and
(printed name of Signer)
ackn• • 1-d_ed that he/she signed the instrument voluntarily for thepurpose expressed in it.
AI L.I� [v1/1av S rdck ist
Signature of Notary Public,StateFlorida '�
f
I Department Approval:
Personally Known
Produced Identification(Type) V 1 V f t!
S l 1 L C OS C
n Scott Williams Put�'Ii�C Director
9� S
fD � o '
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o:\Public Works\ADMIN\Revocable Encroachment Agreement.docx
Revision Date:8/31/18
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RIGHT-OF-WAY/ EASEMENT PERMIT
``- Permit#Issued bythe Cityof Atlantic Beach
�Y��:.t,'�
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address l_�' gel 6,.,,, ,,_ Q, N,,,0.,1 ,, Phone 9 Ci4- a9 - 4q Dg
Permittee C,1 4.41
N.Q,,►: / 6 v.u.c aAvorw•,v Email CloNtt-0 qv%a.AcoR`,\sa, . to "
Requesting Permission to Construct Rc,.c.A.00e,c1r v-e,@wed a xaeet; &r.
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 \....a'e'r.c.\ 4-$P-11dor (Project Superintendent)
with Company Name iftv\ ,`->!c n Pa uthrS Phone 9 fl y-(0,4-.25-13
• 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.
• ' - II i , tor of Public Works shall be notified twenty-four(24)hours prior to starting work and again
••y•dip, upon ci•- . etion.
I'l`do..., Date I 4/2/2..,/8
Permittee(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL e" 1_ �L
The foregoing instrument was acknowledged this_ _day of beC-eYYI r�-e K ,20 1 D
by CrU C. e QrOpi ryi Lr ( Cyh--1 ICG met,.J 4 ,who personally appeared before me and
(printed name of Permittee)
acknoled•.ed that he/she signed the instrument voluntarily for the purpose expressed in it.
/
/40/
# 1 144013S0. LoleCIA Personally Known •
S :na re o otary Public,State of Florida Produced Identification(Type) P'1✓e rS � ) c e i'1 St,
i ;i; MARISSA LORDA
:.•: :* MY COMMISSION#GG 228145
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'''?C °a'' Bonded Thru Notary Public Underwriters -
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MAP SHOWING SURVEY OF
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37A OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
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