368 1ST ST RESO19-0006 REPL DECK ON GRADE RESIDENTIAL OTHER PERMIT PERMIT NUMBER
if) RES019-0006
a: Vr CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 3/21/2019
19r ATLANTIC BEACH. FL 32233 EXPIRES: 9/17/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL •RK MUST CONFORM TO THE CURRENT 6TH EDITION1 OF i '
CODE, OF BEACH CODEOF 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.
1013 ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
RESIDENTIAL OTHER SINGLE OR
368 1ST ST TWO FAMILY RESIDENTIAL replace deck on grade $2500.00
OTHER
TYPE OF •
ZONING: :D •
• • GROUP:
169750 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
ROBERT GWALTNEY INC P 0 BOX 49028 JACKSONVILLE FL 32240
BEACH
• ADD '
WOODS JEFFREY C 303 6TH ST ATLANTIC BEACH FL 32233-5347
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 • . •
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.
Issued Date:3/21/2019 1 of 2
RESIDENTIAL OTHER PERMIT PERMIT NUMBER
J i\
CITY OF ATLANTIC BEACH RES019-0006
�~ 800 SEMINOLE ROAD ISSUED: 3/21/2019
9" ATLANTIC BEACH. FL 32233 EXPIRES: 9/17/2019
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.
4 PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
5 PUBLIC WORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking must be removed from job site by Contractor.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $65.00
BUILDING PLAN CHECK 45S-0000-322-1001 0 $32.50
STATE DBPR SURCHARGE 455-0000-208-0700 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: $151.50
Issued Date:3/21/2019 2 of 2
ri�Ly;y+ City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)_
800 Seminole Road /_F C p l Cl 0000
Atlantic Beach, Florida 32233-5445 G J
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
, I s
Property Address: 3 �� - --Department review required Yes No
Buildin
Applicant: -�nL Planning &Zoning
Tree Administrator
Project: (�Q�LR- �Q�L�- V� «r Public"Works
ublic 0tilities
Public a e y
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. of applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:
TREE ADMIN. Second Review: ❑Approved as revised. ❑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
City of Atlantic Beach APPLICATION NUMBER
S )t� Building Department (To be assigned by the Building Department.).
r n 800 Seminole Road
r' Atlantic Beach, Florida 32233-5445 G J 1 V (J
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.usDate routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Sfi
Property Address: 3 4 � 1 �� ment review required Yes No
Building
Applicant: VJC4 �� l�v , L Planning Zoning
\ ,I Tree Administrator
Project: (L2Vit L ,� �Q�_L �j n G� (l( Public"-w�o—rps_
(-Public Otilities
Public a e y
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. []Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:v� /� Date:3^ r t " t ci
TREE ADMIN. Second Review: ❑Approved as revised. ❑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
-1% I i , City of Atlantic Beach * APPLICATION NUMBER
9� Building Department 3 (To be assigned by the Building Department.).
+n 800 Seminole Road //� CC
Atlantic Beach, Florida 32233-5445 MAR 1 1201 f G J� C1 00
Phone(904)247-5826• Fax(904)247-5845
E-mail: building-dept@coab.us Date routed. t�
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
S
Property Address: 3U ( .. �� - De ar#ment review required Yes No
Applicant: 1 __bbk t 1J!n)ej 4, _JAL Planning &Zoning
Tree A ministrator
Project: (awL L yA <7P=2i oris
ublic tilities
Public-aae y
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. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING /
Reviewed b' Date:
TREE ADMIN.
Second Review: ❑Approved as revised. ❑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
City of Atlantic Beach APPLICATION NUMBER
�s Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
v Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ( J� De artment review required Yes No
�) ildin
Applicant: C, , L Planning &Zoning
Tree A ministrator
Project: (�Q�� C C k C)A J(J (-Pubic( s`
ublic Utilities
Public a e y
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. ❑Not applicable
(Circle one.) Comments:
BUILDI
PLANNING &ZONING
Reviewed by: Date: 1 201
TREE ADMIN. Second Review: []Approved as revised. []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
Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department "ALL INFORMATION
�< <r 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: :� c 4e 6 ( +. Permit Number: ��iS 0
Legal Description Lo'- 2 1 13100 Z Wy,� Nh- UA 14 SQL 2 RE#
Valuation of Work(Replacement Cost)$ 2_,, 50o Heated/Cooled SF cz, Non-Heated/Cooled
• Class of Work: 91,ew ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool [`_]Window/Door
• Use of existing/proposed structure(s): ❑Commercial 1 Rsesidential
I�AR - 5 2019
• If an existing structure,is a fire sprinkler system installed?: Dyes ❑No !,
• Will trees be removed in association with proposedproject? ❑Yes must submit separate Tree Removal Perrrrit -bJ o
Describe in detail the type of work to be performed:
i
Florida Product Approval# ) for multiple products use product approval form
Property Owner Information
Name 01a_V c7 U-)on L Address
S�
City . CkN State J:'�L Zip 3 Phone `IO'li • 2141 -99-73
E-Mail O tc) `
Owner or Agent(If Agent, Power of ttorney or Agency Letter Required) 71
Contractor Information u ,,�GT�/t y !A�L l /
Name of Company Qualifying Agent
Address K v. Q ox 014 O 2- f City ISL State�_Zip 3 LLS a
Office Phone el 014 17 3 (v / S-0 Job Site Contact Number
State Certification/Registration#C-6Cuyy s5-7 E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR ExempAwDExpiration Date 2-040
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 YOYR PROPERTY. IF Y INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR 0 ATTO NEY B FO E
RECO RDING YOUR NOTICE OF COMMENCEMENT. /
(S nature of Owner or Agent) (Signature f Contr tor)
Signed and sworn to(or a irm for me this 5-day of Signed pnd sworn to(or affir )before a thisI day of,..
6
a/kc)h 20\01R9NA 9-6q
1
ignature of N tary) °.KiI I" '4MM9fAMff*kL
c/ #r ;>>mmission#FF 218261
�• f* €mi.esA tl17,2019
[ ]Personal) ia2i"" TONI ONDLESPERGER [ ] ersonally Known OR �R„ dad ThN Troy Nin leMxance 8003B5JOt9
`= .- MyC044MISSION0FF924951 �roduced Identification
[ ]Produced": fon EXPIRES:October 6,2019 ` �.11►5���y�-�.-.
Type of Iden iCt{tiiJ"'' g �F Type of Identification:
,WALK .
BEARING REFERENCE
4.7 •:: :.tes�.•.�. ... 50.0 (R) (R) _(—_ --- -
".`:•• •.:: 4 5.00 TO EAST COAST DR.
Ci51V�RETE =.
DRIVE
Abbreviation
: ,:.�.•.: N Table
Abbrev. Code Descrip
Y':-.. . " , •�d CONCi ETE PC PRINT
• pRIVE CURVAT
PT POINT
ti 16.0 86
w TANGEP
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—0- 62 n D CURV
11 38.9-\ �. ORV OFFICI
O I N RECOR:
VOLM'
O R/W RIGHT OF
ONE STORY WOOD & i r? ROW RIGHT OF
ONE STORYMASONRY RESIDENCE #368 X38 8.6 BK BOOK
WOOD & 374 LLI N I PG PAGE
p0 31 a POB POINT
X BEGINNI
II 4' 1_1/4 A/C N COV'D COVER[
O 18,8 \UA, WELL 16.0 M STRUCTI
O APPROX APPROXIN
6'2 Z BLDG BUILDII
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4/r 00 �-1-t' , R RADIO'
C n. -Cu �X 1 '�l Q SEC SECTIO
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CONDITIOI
Z M CH CHORD LEI
`16.b cI_---- `_ L ARC LEN(
0 wOH OVERHE/
z w WLOT 1EST 9 2 EAST 1/2 TR E TRACT
0 Lu OT 19
w o LOT 21 i F BLOCK 2 z BOCK 2 PT POINT E
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w
g b SECOND:
' p AIR
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Synbol Tnble
0 50.0 R 25.0 (R) 0, Cade Description syf*
( ) 6' WOOD FFNCE LP LIGHT POLE
-- VAMVS WATER METER MV
0'0, i ELPME
I a S89°38'13"E 75.03 DEED
j Hatch Tabte
ERAL NOTES: i LOT 22, BLOCK 2 LOT 20, BLOCK 2 LOT 18, BLOCK 2 CONCRETE
UNDERGROUND UTILITIES OR STRUOTURES LOCATED. STEPS
UTILITIES LOCATED EXCEPT AS MAY BE SHOWN HEREON.
ATTEMPT WAS MADE TO LOCATE JURISDICTIONAL WETLAND LINES COVERED
R TO NOTIFY THE PROPER AGENCIES.
STRACT OF TITLE WAS NOT FURNISHED TO THE UNDERSIGNED. COVERED GRATE
2TICAL DATUM BASED ON THE N.A.V.D OF 1988. y- Synbol Table
3 /„8l ✓ S`�: Code Description synb
ED USE AND DISCLAIMER lY(/ i VATMET VATER METER
USE OF THIS SURVEY, YOU AGREE TO BE BOUND BY THE TERMS WRITTEN ON THIS FP
CPIPF IRON PIPE
f.
CPDF •
iIS SURVEY IS INTENDED FOR SOLE USE OF THE PARTIES CERTIFIED HEREON. GRT GRATE
3 PARTY SHALL ASSIGN THIS SURVEY DRAWING OR ANY INTEREST OR i;-FC SIG
3LIGATION HEREON WITHOUT THE PRIOR WRITTEN CONSENT OF THE UNDERSIGNED. CTL CONTROL
JY REPRODUCTION OF THIS SURVEY IS PROHIBITED. OY�'G\ >Ps ]SET r Ra oeea>
BANKS&BANKS
I HEREB Y CERTIFY TO.
CONSULTING, INC. JEFFERYANDCAROLYNWOODS
'' 83 WEST 9TH STREET ATLANTIC BEACH,FL THAT THIS SURVEY MEETS THE STANDARDS OF PRACTICE AS SET FORTH BY THE
(904)-6852800 FAX(904)-686-2345 FLORIDA BOARD OF SURVEYORS AND MAPPERS UNDER THE DEPT OF
AGRICULTURE AND CONSUMER SERVICES,PURSUANT TO SECTION 472.027 FLOR,
A GEOSPATIAL COMPANY
STATUTES AND CHAPTER SJ-1Z�50
FLORIDA ADMIN/S77RATIVE CODE
BANKSANDBANKSCONSULTING.COM -
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