1717 Beach Ave ACC19-0035 Pavers a' ACCESSORY PERMIT PERMIT NUMBER
,rr ' ACC19-0035
CITY OF ATLANTIC BEACH ISSUED: 5/13/2019
800 SEMINOLE ROAD
EXPIRES: 11/9/2019
ATLANTIC BEACH. FL 32233MUST CALL
INSPECTION • • 1 • FOR DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' 1 . BUILDING
CODE, NEC, IPIVIC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF READ
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.
1717 BEACH AVE ACCESSORY SINGLE OR TWO REPLACE CONCRETE WITH $15000.00
FAMILY ACCESSORY PAVERS
TYPE OF ZONING: BUILDINGSUBDIVISION:USE
CONSTRUCTION: NUMBER: GROUP:—
NORTH ATLANTIC BCH
169662 0000 UNIT 1
COMPANY: ADDRESS:
CORNELIUS 218 Bay Street Neptune Beach FL 32266
CONSTRUCTION CO.
OWNER: ADDRESS:
HADLOW NANCY P 1717 BEACH AVE ATLANTIC BEACH FL 32233-5838
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 Lire(904-24]-
5814)10 request an Erosion and Sediment Control Inspection prior to start of construction.
Issued Date:5/13/2019 1 of 2
'- ACCESSORY PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ACC19-0035
ISSUED:5/13/2019
800 SEMINOLE ROAD EXPIRES: 11/9/2019
ATLANTIC BEACH. FL 32233
2 PUBLIC W00.KS �11E INFORMATIONAL
Notes:
All runoff must remaln on-site during construction.
3 PUBLICWORKS ROLL OFF CONTAINER INFORMATIONAL
Notes:
Rall off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapelis,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.
4 PUBUCWORKS RIGHTOFWAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
5 PUBLICWORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PU REVIEW BURDINGMODORROW 001-0000-329-1W] 0 $25.00
PW REVIEW BUILDING MOD OR ROW 001-0000.329-1000 0
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0po0-32-1003 0 $50.00
TOTAL:$100.00
Issued Date:5/13/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
- Building Department (To be assigned by the Building Department.)
1 800 Seminole Road !� y1 _ O O? C
Atlantic Beach,Florida 32233-5445 A
Phone(904)247-5828 Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http'.1/www.WWUS -
APPLICATION REVIEW AND TRACKING FORM
Property Address: 17 J
17 1 E RCts( r De artment review required Yes No
Applicant: 0- O R(v E.Lt us C cwasT
TreeAdmi nZisotrnaitno
r,
Project: R&PC e6 Cot_ CR_ET6
is Works
fties-
1 UA c CLS CA-. t `r II Q iyV 2-S Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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: pproved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING �j ��ij
PLANNING &ZONING Reviewed by� /moi— Date: P_7- Iq
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: Dale:
Revised 05/1912017
YS,arlrT,: City of Atlantic Beach APPLICATION NUMBER
.} 9� Building Department (To be assigned by the Building Department.)
i 800 Seminole Road n �!h n _ 0 O C
.. Atlantic Beach, Florida 32233-5445 ly l.. `), v--�
Phone(904)247-5826 Fax(904)247�6p45
E-mail: building-dept@wab.us — Date routed:
City web-site: hltp:/Avww.coabos
APPLICATION
/t1REVIEW yAND TRACKING FORM
Property Address: ' � 1 7 I.,E A�(=( 1'1V� Department review required Yes No
Applicant: e O R N [ L_I U S �O I ST nnmg &Zor
(� n Tree Administrator,
Project: is vvodcs
ibes
UJ(ALAKs (atIcet �{avE25 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 Riverview Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: li4piproved. ❑Denied. ❑Nat applicable
(Circle one.) Comments:
BUILDING / _ y
PLANNING&ZONING Reviewed by✓ Date:J -
Uf
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:
Revise)05119/2011
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
600 Seminole Road (R e� (\
Atlantic Beach, Florida 32233-5446 ly l.. `1 J�
Phone(9D4)247-5826 Fax(004)247-5845 25
E-mail: building-dept@mab.us Date routed:
City web-site: htto//wmv costa us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 -7 17 I�/t1)E A -Department review required Yes No
Applicant: e .R(Q I=LI CJS C-o A�Ls nning&Zonin
Cn Tree Administrator,
('�E
Project: I'� p C ec- -Od'— . c— is Works
i,k )A Cr«S C. 9 I [ K W Vc-9-S Public Safety
Fire Services
Review fee $
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 Tabs=
Other:
APPLICATION STATUS
Reviewing Department First Review: ❑Approved. ❑Denied. HC 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 0511912017
Building Permit Application Updated ID/9p5
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
u`
Phone: (904) 247-5826 Email: Building-DeptCdcoab.0IS REQUIRED.s n �
Job Address:_M 1 1 13"GH A 1F_ Permit Number: A�`-- 19 - CO�'JC
Legal Description N ATLaunC F2r UNIT I Llff 1-1 REN II JALT_
Valuation of Work(Replacement Cort)$ 1.5. 6C8.60 Heated/Cooled 5F_14A _Non-Hea[ed/Cookd Ffd4
• Uassof Work: ONew ClAdd'nion DAlteration ,gcc,,/IReper QMove DDemo OPool DWIndow/Door
• Use of existing/proposed structure(s): OCommercial Residential
• If an existing structure,is afire sprinkler system installed?: Dyes 4 No
• Will r removed in ass"i,tion with proposedr 'act?EJYes Indust submit senarate Tree R ntvale rmit o
Describe in detaR the type of work to be performed:
REPJ-ACE CoxnICR T� WIT" PA IF�ZS
Florida Product Approval If NA for multiple products use product approval form
property Owner Infoqrmr�a1tio^n,1,
Name Ml,l(q NNI/ 1Lt Address Ir/Ifl BaCH- AIIF
City PFTL BG-F State F) Tip 37-2313 Phone MAY 6 201T—
E-Mail E- Mail
Owner or Agent(H Agent,Power of Attorney or Agency Letter Required)
Contractor Information -
NameofCompany <fogl, ELdUS aRSTIl UClrDld Qualifying Agent ',TLS.
Address Z _ CityState Zip A7Z(oCo
Office Phone Z<G Job Site Contact Number
State Certlfiration/Regirtrationd C45Ct)%)5 kq E-Mail PEFr64(d-/ARNEUU L<M6N1(Z_0
Architect Name&Phone a
Engineer's Name&Phone a
Workers Compensation Insurer OR Exempt 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.l 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 ofthis
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 govemmental 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
REG IMhC�j� MENCEMENT.
til.! '////
(Sign re ofOwner or Agent) I (Signatureof Contractor)
i ed and sworn to r affje ) , 's yof ed and swornto(o affi before his r W tb4NIGINDI- SPERGE Na a )
r My COMMISSIGJa FF924951 +.
a EXPIREG'Octcberu1£ _emonally Known OR
jlirodicedl ( i Produced ldenuPtw ra , ' ; MYTCAMMI8SIOENBFF924951
Type of kkntlfiolbn: F45 o-(a,g s-44 71sowodentifiratian: O=tw6 M19
BonEM ilia Ncnry Pu b4c UrdemOers
TREE&VEGETATION AFFIDAVIT FOR BOERM01L OFFKEUSEONLY
City Of Atlantic Beach PERMIT S
Community Development Department
_ 80O Seminole Road Atlantic Reach,FL 32233
(P)904247-5800
SITE INFORMATION
ADDRESS 1717 Beach ave
SUBDIVISION NANamic Beach BLOCK t LOT 19
RE# 7595620000 N RESIDENTIAL ❑ COMMERCIAL ❑OTHER
APPLICANT INFORMATION
NAME Nancy Hadlow PHONE#
ADDRESS 1717Beach AVe CELL#
CITY Atlantic Beach STATE FI DECODE 32233
EMAIL ❑X OWNER ❑ LEGAL AUTHORIZED AGENT
1 affirm that I have reviewed the provisions of Chapter 23, 'Protection of Trees and Native Vegetation',of
the Municipal Code of Ordinances for the City of Atlantic Beach Florida and/or I have participated in a pre-
application meeting with the Administrator of those regulations. Subsequently,I affirm that no regulated
trees and no regulated vegetation will be damaged,destroyed and/or removed from the above-described
property and/or adjacent properties including rightof-way.
�I HEREBY CERTIFY V'/{/;�T/ RffORM71TON PROVIDED IS CORRECT:Signature of Property Owner(s)or Authorized Agent
l ti�'1 I'(,(,C�(XJ( '— Nancy Hadlow
SIGNATUREO APPLICANT PRINT OR TYPE NAME DAiE '
SIGNATURE OF APPLICANT(2) PRINT OR TYPE NAME DATE
Signed and sworn before me on this--&day of V0 Q-', ;-Pby State of
myof
Identification verified: r 1o' '
Oath Swom: ❑Yes ❑ No
TONT CINDIESPERGER Notary Signature
MY fAM1716510NOFF9N4 I
H EXPIRES'.Ocmbel 6.2019 My Commission expires
�,�'. Bonv'.^.tlinw NTary Gutllicllntlewners
04 TREEAND VEGETATIONAFFIDA
a.va- �� UIa E. •_
EROSION CONTROL LINE 50001
OFFICE COPY
Approved By Permit Desk
CY a NR.MONUMENT Ih Building Department
' " R-45 0) City of Atlantic Beach,FL Q
1Fi
Ir x so-2s'00"W O
On
N
I z.00' OLD COASTAL CONSTRUCTION
' SETBACK LINF!CC9L)... — Q)
492.24
ouxON PiPE� 5G41°5t9'41'E
L&3672 LTR<VERSE.
LINE
aINE ONLY
a — -
K .a
NOTES
THIS ISA BOUNDARY SURVEY. CONCRETE PATIO
zna STORY
NO BUILDING RESTRICTION LINE PER PLAT.. w0OD MLLa"Y
a' 9.e
BEARINGS BASED ON THE OLD COASTAL 35E
CONSTRUCTION SETBACK LINE FOR DUVAL
COUNTY,FLORIDA. ox.3' �
CURRENTCOASTAL CONSTRUCTION SETBACK
LINE NOT LOCATED BY THIS SURVEY. - —
BENCHMARK USED IS A NAIL 8 DISK (LEL 3672) 2 STORY -
IN PALM ON LOT 19. ELEVATION= 16.20 NGV.C. 00--'a
= FRAME RESIDENCE
nr
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