1730 E Park Terrac ACC19-0039 Paver Patio ACCESSORY PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ACC19-0039
800 SEMINOLE ROAD ISSUED: 5/24/2019
ATLANTIC BEACH. FIL 32233 EXPIRES: 11/20/2019
— I
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.
io e
N I E-in dd, n th en 5 his e it,th a be add ional restrictions applicable to this property
OT C - "'. to e" qu.rem t of P rm r.To Y '0 1 tho
that may be found in the public records of this county,and there may be additional permits required from other
governmental ent�lties such as water management districts,state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUEOFWORK:
1730 E PARK TER ACCESSORY SINGLE OR TWO PAVER PATIO $7500.00
FAMILY ACCESSORY
TYPE OF REALESTATE BUILDING USE
CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION:
1720200394 SELVA MARINA UNIT08
COMPANY: ADDRESS: CITY: STATE: ZIP:
MOORE PAUL PHILLIP 1730 PARK TER E ATLANTIC BEACH FL 32233
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 containercompany mustbeorl approved list. Containercannot be placed on City right-of-way.
PUBLiCWORKS 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 anErosion and SedimentControl inspection priorto startof construction.
2 PUBLICWORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
issued Date: 5/24/2019 1 of 2
ACCESSORY PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ACC19-0039
ISSUED: 5/24/2019
800 SEMINOLE ROAD EXPIRES: 11/20/2019
ATLANTIC BEACH. FL 32233
===T=3 PUBLIC WORKS POST CONSTRUCTION TOPIC SURVEY INFORMATIONAL
Notes:
if on-site storage is required,a post construction topographic survey documenting proper construction will be required, Allwath rrun 'arug'o
retention area and retention overflow must run to street.
4 PUBLICWORKS ROLL OFF CONTAINER INFOR��11110CINT
Notes:
Roll off container company must be on Cityapproved list(Advanced Disposal,Realco Recycling,Shapells,Inc.,Republic Services,Donovan Dumpsteri,
Phillips Containers,JDog/Denris Junk Removal,All American Roll Off,WCA Waste Corporation). Container cannot be placed on City right-of-way.
5 PUBLIC WORKS RIGHT OF WAY RESTOR ION INFORMATIONAL
Notes:
Full righI restoration,Including sod,is required.
6 PUBLICWORKS RUNOFF MATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
=�
3 P UCWORK��
UB S
'"moff Mug'a
'T'CNA'
JBL C WO RKS ROLL OFF CONTA NER M
Co.-y"a Dumpsla.,
C, right of Way
RIGHT OF WAY RESTORAT
PIBIII WORKS
FEES
DESCRIPTION ACCOUNT PAID AMOUNT
BUILDING PERMIT 4S5 0000 322 1000 0 $W.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $45.00
PW REVIEW BUILDING MOD OR HOW 001�329-1004 0 $25M
STATE DBPR SURCHARGE 455-CO0CE2DP07CO 0 $5.os
STATE DCA;5CHARGE 45 Do 1 0 $3.35
YAORKWTHOUTPERMIT 7_M1222±100K) 1 $2001
S
0
ZONING REVIEW SINGL�AND TWO FAMILY USES WrEKCCOC,32�1003 $SiEoo
TOTAL:$418.38
Issued Date:5/24/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department s� D (To be assigned by the Building Department.)
800 Seminole Road R\ QQ q - 0-0-sC4
Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@caalo.us Date routed
Citywelo-site http://�.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review re uire No
'�—u Iding
Applicant: 0 uj AID P=� Rann—ing 14Z
Trae Administrator
Project: 0 �Ico a
Public SalefT�
Services
Review fee $_Dept Signature
Review=P� Date
Other Agency Review or Permit Required ofPermit
Florida Dept of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Anmy Corps—.fEngmee.
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
I Other:
APPLICATION STATUS
Reviewing Department First Review: 09,P'P"ved. E]Denied. E]Not applicable
(Circle one.) Comments:
(E9
PLANNING &ZONING Reviewed by:—M., Date:
TREE ADMIN. Second Review: []Approved as revised. [:]Denleff. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC S AFETY Reviewed by:_ Date:—
FIRE SERVICES Third Review: ElApproved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date:—
RevIsed05,4912017
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
Roo Seminole Road
-5445
Atlantic Reach,Florida 32233
Phone(904)247-5826 Fax(904)247-5845 Date nuted
E-Mail: building-dept@corubus
City web-site min//www,co2b.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 173C) Department review require Yes No
�ng
Applicant: _pWn—ing&ZomnE>
1 lee�ullledstrator
Project: P L�_—c 0 C Wo S
�nu lic UtilitieiL>
Public ga_fely�
Fire Services
Review fee
Other Agency Review or Pennit Required Review or Receipt Date
of Permit Verified BY
Florida Dept.W—Environment.1 Protection
Florida Dept.of Transportation
St.Johns River Water ManagemeWt Di�sbict
Army Corp._&E.gm...
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
JNot applicable
Reviewing Department First Review: /2<pproved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed b14&� Date:
TREEADMIN. S ..nd Rinnew. E]Approved as revised. DDenied. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:—
FIRESERVICES Third Review: DApproved as revised. ElDemed. E)Not applicable
Comments:
Reviewed by: Date:—
Revised 0511912017
City of Atlantic Beach IV APPLICATION NUMBER
Y . u, P.7"]
be e�d th B_Idling D
Aly�,' Q_sc�
Building Department Y 16 be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach,Florida 32233-6445
Phone(904)247-5826 Fax(90,41)247-5845
E-mail: building-dept@ccalb.us —TDDate routed:
Citymb-site: hftp:/A~.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: PorpXTeap Do artment review required Yes No
,2611c_HM2�� —
Applicant: GIL) ND _QtORng&Zo�
Tree Administrator
Project: PA--cc 0 111c
�Ut- -
Ill.
j�,�u licUtilifie§>
Public Sarfef�y
Fire Services N
Review fee $_ Dept Signature
Rte—vimor Receipt Date
Other Agency Review or Permit Required of Permit Verified By
Florida Dept.of Environmental Protection
Morida Dept of Transportation_
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: E]Approved. VDenied. E]Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed lby�
TREEADMIN. SecondReview: VApprovedas revised. E]Denied. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed 41�206& 0;�Dat-1t_;12:/f
FIRE SERVICES Third Review: ElApproved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date:—
Revised 0511912017
CITY OF ATLANTIC BEACH
,/"�Aft Department of Public Works
1200 Sandpiper Lane
Atlantic Beach, FL 32233
(904) 247-5834
PUBLIC WORKS PLAN REVIEW COMMENTS
Date: 5/17/19 Applicant: Michele Moore
Permit#: ACC19-0039 Email: ppmoore(a)live.com
Review Status: DENIED Contractor: Lima Stoneworks, Inc.
Site Address: 1730 Park Terrace E. Email: lima(&Iimastonework.com
THIS PLAN REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS
Correction Items must be submitted to the Building Department at 800 Seminole Read.
Submittals that respond to only one or a few correction items will not be accepted.
Revisions may not be submitted until ALL departments have completed their respective reviews.
Revisions must be submitted to the Building Department and must respond to EACH department review.
PUBLIC WORKS CORRECTION ITEMS:
• Section 24-66(b)of the Land Development Regulations requires on-site storage for increased
run-off if adding 250 SF or more impervious surface. Provide Delta volume calculations and
on-site retention required per Section 24-66(b).
• Provide a detailed plan of water retention area and how water runoff gets to water retention
areas and then to street. APPROVED
PUBLIC WORKS CONDITIONS OF APPROVAL: t
(Thefollowing comments will be printed an yourpermit as Conditions of Approval) 2_,12.
• 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.
• All runoff must remain on-site during construction.
• If on-site storage is required, a post construction topographic survey documenting proper
construction will be required. All water runoff must go to retention area and retention overflow
must run to street.
• 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.
• Full right-of-way restoration, including sod, is required.
• All runoff must remain on-site. Cannot raise elevation.
Scott Williams, Public Works Director swilliamsLOcoab.us/904-247-5834
Page I of 2
0APublic W.rkS\ADM1N\PLAN REVIEW COMMENTS\ACC19-DO39(Oner-Moom).do.
Resubmittal Notes: All revisions and changes shall clearly stand out from the rest of the drawing on the sheet as a
revision by way of completely encircling the change with"clouding". The revision shall also be identified as to the
sequence of revision by indicating a triangle with the re%rislon sequence number within it and located adjacent to the
cloud. The revision date and revision sequence number shall also be indicated in a conspicuous location in the title block
for each sheet on which a revision for that sequence occurs. For projects still in the initial review stage and permit
pending,all sheets with revisions shall be inserted into each set of drawings. The original sheets must be clearly marked
"VOID" but are to be left within the set of drawinjzs. Complete new sets of drawings will not be accepted. ADDITIONAL
ITEMS MAY BE REQUIRED DEPENDING UPON NEW INFORMATION AND CLARITY OF FINAL PLANS SUBMITTED FOR
REVIEW.
Page 2 of 2
0-.\Public Works\ADM1N\PtAN REVIEW COMMENTS\ACC19-0039(Owner-Moore).doot
City of Atlantic Beach APPLICATION NUMBER
Building Department D (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach,Florida 32233-5445
Phone(904)247-5B26 Fax(904)247-5845 L 9
E-mail: building-dept@coab.us Date routed: ELI
City web-site: hftip:/�www.coaous
APPLICATION REVIEW AND TRACKING FORM
Property Address: 17'-7
F49 0 nt review required Yes No
Applicant: (D cp ND c_4� _219ff—ning &Z�5p
Tree Administrator
Project: I�K P 1�-_-_c[ 0 %t�o 6 �
ek>
7--
Fire Services
Review fee $_Dept Signature .11, 11, —1, 11
Review_orR�eipt —
Other Agency Review or Permit Required of Permit Verified By Date
Florida Dept of Environmental Protection
_�Iorida_0.ptof Transportation
St.Johns Ri er Water Managernment District
kmy Corps of Engineers
Division of H 3tels and Restaurants
Division of Alcoholic Beverages and Tobacco
er
APPLICATION STATUS
Reviewing Department First Review: ElApproved. ElDenled. ot applicable
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by: L"Zlk--�Date: S4741
TREEADMIN. Second Review: E]Approved as revisel ElDenied. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:—
FIRE SERVICES Third Review: []Approved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date:—
Revisoij OsI9120117
Building Permit App cation Updated 10/9/18
City of Atlantic Beach Building Department --ALL INFORMATION
HIGHLIGHTED IN GRAY
800 Seminole Road, Atlantic Beach, FL 32233 ISREQUIRED.
Phone: (904) 247-5826 Email: Bljilding-Dept@
JobAddress: j7qpparkje,,a,g lost.Atlactr Beach.FL32133 PermitNumber. Ac'eig — oc)39 11
Legal Description RE#
Valuation of Work(Replacement cost)$ 7,500 Heated/Cooled SIF 0 Now Heated/Cooled---950—
• CIae,,fWork: (NNew OAddition OlAfteration 01tepair 0move 0Demo OP001 OWindow/Door
• Use of existing/proposed structureisl: OCmmercial IgResidential
• Ifan existing structure,Is afire sprinkler system Installed?: OYes INNO
• willtreels bar- _vedl association with proposed proj-t?Dyes(must submit separate Tree Removal Permit) MNo
Describe In dt.11 the type of work to be performed: Install concrete paver over existing covered patio and extending patio
Florida Product Approval#�for multiple products use product approval form
Property Owner Information
Name Michele Moore Address 1730 Park Terrace East
City Atlantic Beach State FIL Zip__322Ljj_Phone 904-616-1025
E-Mail 13111110nare(Plive-COrn
Owner or Agent(if Agent,Power of Attorney or Agency Letter Required)
Contractor Information
NameofCo A Ag Ujoa 9) <-//j fb f AAAC64 Jo
any �' Quallivil g ent
Address IM/Fla F5 A AV 5 /�e zlp_2AA�
ter
Job Site 2ntact Nu�mAer_j_f I:ZIL
Office Phone(_142_4VL_'��,5
State artification/Registration# C Q'm
Architect Narne&Phone#
Engineer's Name&Phone# to R Exempt 0 Expiration Date
Workers Compensation Insurer
Application is hereby made to obtain a permit to do the work and Install tions as indicated.I certify that no work or Installation has
commenced Imor 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
RECORDINGVOUR140TICE OF COMMENCEMEN�m��
(Sig"tu e ofOwner or Agent) snn.xxefCcm.�1.r�
1A, before met is day of
Signed and swum to(or affirmed)before me this I day of d d a k7,us k�
_flal� Aril') by =Z11a 0 k
Aj'c� 7 in ture U
-1 (Stenature of Notary)
--f,l Personally Kr.wn Personally Known OR
[ I Prduccal ld.nlfl "P Z
Type of tdantiticutfun Type
'-ALL INFORMATION
owner Builder Affidavit HIGHLIGHTED IN
'U
,1 City of Atlantic Beach Building Department GRAY IS REQUIRED,
J,ot 1" 800 Seminole Rd, Atlantic Beach, Fl.32233
Phone: (904) 247-5826 Email; Build!nFLD_QP1L@LqB_bus PERMIT#:
1. FLORIDA STATUTES;CHAPTER 489,FLORIDA STATUTES,PART i"CONSTRUCTION CONTRACTING'REQUIRES
OWNER/BUILDER TO ACKNOWLEDGE THE LAW:
DIS-0,SWESPIE1.11E .
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.
UE OR TWO UFAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY
Y06 MAY BUILD OR IINI
ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COSTOF$25,000.00 OR LESS
THE BUILDING MUST BE FOR YOUR:USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
,���6UHAVE BUILT�YOURSEUF WITHIN ONE YEAR AFTER THE
IFYOU SELL OR LEASE ABUILLI ASE,WHICH
CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LE
IS IN VIOLATION OF THIS EXEMPTION. MUST
YOU MAY Of HIRE AN UNU ENSED PERSON AS YOUR CONTRACTOR,YOUR CONSTRUCTION
BE ONE ACCORDING TO I tit BUILDING CODES AND ZONING REGULATIONS.
IS YOUR RVI 'OU HAVE LICENSES
__5B
I REGIRE STATE LAWAND BYCOUNTYOB MUNICIPAL ULt--u1U ORDINANCES.
11. INJURY LIABILITY;SINCE OWNERS MAY BE LIABLE FOR INJURIESTO WORKERSTHEY HIRETHE BUILDING DEPARTMENT
SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. , IRSWITHHOLDING
Ill, IRSWITHHOUDING;OWNERS HIRING WORKERSBECOME EMPLOYERSAND SHOULDALSO OBSERVE I T TRADES
TAX AND/011 FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMEN RSBEIN 'SUBJECT
IV. PENALTY;UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES.OWNE G
TO$5,000 PENALTY UNDER FLORIDA STATUTE NO�455-228(l). AN"OCCUPAnONAL LICENSE-IS NOT ADEQUATE. THE
OWNER SHOULD PHYSICALLY SEETHE COUNTY'CERTIFICATE OF COMPETENCY'OR THE FLORIDA"CONTRACTORS
CERTIFICATE"To ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904-
247-58260RO�LILI);N-G—DEPFP90—At�-.t)q)IFIN 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.
JobAddress: 1730 Park Terrace East,Atlantic Beach FL 32233
OwnerName: Michele MOD�re Phone Number, 904-616-9944
MaillngAddress: 1730 Park Terrace East City: AtlantIcBeach State: FIL Zip: 32233
NortarizedSignaturefffOwner 'A
The foregoing Instrument was acknowledged be ethlsja.�dayof Mcult 20J_L In the State of Florida, County
of
Signature of Notary Public dil P, -
I
JULIA P. MITCHELL ally Known OR( I Produced ld:ntiflcation
Notary P.131I.-SUR.of Florida '*M Person
E. Commission If GO 320340
my commission Expires
April 21,2023 Type of Identification:
UpdoledlW4,48
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