2213 Alicia Ln ACC19-0051 paver patio permit C CL
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_,-4 Building Permit Application Updated 12/8/17
u City of Atlantic Beach E..M A-L(---€ C Z`l 4/Z a
4t qw, 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 �, (:.I ,_J
Job Address: a a i 3 n1'l U a, L 1L1 1L ``Permit Number: hl - 005
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Legal Description 4CP-9L137-as-a9E T'-ffan3 6T44,15kA Lo+gRE# ICP 1siq-47fO
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Valuation of Work(Replacement Cost)$ /3 j 000 Heated/Cooled SF in Non-Heated/Cooled KA
• Class of Work(Circle one): New Addition (Alteration)Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercia Resident ti 1',`
• If an existing structure,is a fire sprinkler system installed?(Circle one): -Yes NoN/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: a,.eti-t o d ra yt,
Ex C_CkVa.*.i.m-t.. 0-F Pa> r area rY ia.r k- d Y1 d esisn . Gi ad-e_
properly• 5e-I-draJns and pipeto ri&v -F-Fin sa.id°--eas. Ins+attpaLiersipiaa,-l-erwaU4
4 `:rePite.(e4.
Florida Product Approval# I1)A for multiple products use product approval form
Property Owner Information , a) i c I•a L �
Name: S4&r1je y Deem Address:
City R+I OYri-i c. Chea'-t-I" State FG Zip 3 a.a33 Phone g/ 7— 1103— ��tP
E-mail s+anley9 d'n-n-16P_vrYucl k-Cowl
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: 0-r4-I'1 j,OOr 5 Qualifying Agent; SUkt►" aCG k IOri E'i q I.
Address 1 asci( Q co.c - 431vd City �act'sm'�Vi Ice, State FL Zip 3 aatic /
Office Phone 9 b9- 99 ho- MI`d., Job Site/Contact Number 9 09-3119-Q Sort
State Certification/Registration# SI DI I 0 31$ E-Mail m -a. d':.e ar+hwork s* C QYVl
Architect Name&Phone# /'-/4
Engineer's Name&Phone# 1v4 19- N�I I a+0
Workers Compensation L.)C- 5t'�n- (I"`7 y --05 4(1'
Exempt/Insurer/Lease Employees/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 regulationg
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 • :TAIN Fl t.NCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
REC•.�•IN, YOU' OTICE (lc COMMENCEMENT.
- � ":„0"' (Signature of Contractor)
0
(Signature of Owner or Agent) i/
(including contractor)
Signed and sworn to(or affirmed)before me this y-day of Signed and sworn to(or affirmed)before me this day of
3-1-•rye. , .Q0/9 ,by `J'fcui l e,y .1),0414.tJ0 Sta.+,.n.- , 1 O t q ,by Ta_s 01/1 Dur n. -.
g n' Si nature of Notary)
i MANDI FUTGH r'..! '. I+IANDI FUTGN
R' a P/ersonally Known ORte
r
[ Personally Known OR9,',� kV COMMISSION€GG 2069.? [ ;Jl'COMMISSIOtJ#GG 206983
• Produced Identification o EXPIRES:Apn112,2022
[ J produced I icatiolcatip . .Q_' EXPIRES:April 12, O •. �
Type of Identification: `•'!`°.' Bonded Ttru Notar"v"b4i' Type of Identification. ae s
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'ERTY ADDRESS:2213 ALICIA LANE ATLANTIC BEACH,FLORIDA 32233 SURVEY NUMBER: FL1312.23
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WORK DATE: 12/31/2013 REVISION DATE(S):(REv-o 12/31/2013)
ATABLE: )4-�l/l�. ,�t'Z
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UNDARY SURVEY N 8°0828°W 75.81'(M)
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Earth Works, Inc.
12501 Beach Blvd
Jacksonville 1224
Stan Dennis
2213 Alicia Lane
Atlantic Beach, FL 32233
(904)229-5070
Date: June 24, 2019
Drawing Scale: V=24' (KS
Designed By: Earthworks, Inc
Revisions:
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Earth Works, Inc
12501 Beach Blvd ^
Stan Dennis
2213 Alicia Lane
Atlantic Beach, FL 32233
(904)229-5070
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Date: June 4 2019
Drawing Scale: V=25' (K K)
Designed By: Earthworks, Inc
Revisions:
SHEET TITLE
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Earth Works, Inc
12501 Beach Blvd ^
Stan Dennis
2213 Alicia Lane
Atlantic Beach, FL 32233
(904)229-5070
i
Date: June 4 2019
Drawing Scale: V=25' (K K)
Designed By: Earthworks, Inc
Revisions:
SHEET TITLE
Dimension Pla
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This symbol indicates that these light
will not be installed due to the light
interfering with the sea turtles.
R Wall light (7)
� Up light (4)
COMMUNITY DEVELOPMENT
APPROVED
Earth Works, Inc.
12501 Beach Blvd
Jacksonville, FL 32246
L
enniscia Laneh, FL 322339-5070
Date:June 24 2019
Drawing Scale: 1"= 24' (K R)
Designed By: Earthworks: Inc
Revisions:
SHEET TITLE
Removal Plan
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PUBLIC WORKS
{/PPROVED
{ } DENIED
{ } NOT APPLICABLE TO DEPT
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Earth Works, Inc
12501 Beach Blvd
.lack.-onville_ Ft 3274(3
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Date: June 4, 2019
Drawing Scale: 1" = 10' (KSR)
Designed By: Earthworks, Inc
Revisions:
SHEET TITLE
Dimension Pia
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Earth Works, Inc.
12501 Beach Blvd
Jacksonville, FL 32246
F
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aLane
, FL 32233
-5070
Date: June 4, 2019
Drawing Scale: V=10' (K R)
Designed By: Earthworks Inc
Revisions:
SHEET TITLE
imension Pla
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SHEET
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Earth Works, Inc.
12501 Beach Blvd
Jacksonville, FL 32246
F
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aLane
, FL 32233
-5070
Date: June 4, 2019
Drawing Scale: V=10' (K R)
Designed By: Earthworks Inc
Revisions:
SHEET TITLE
imension Pla
L-2
SHEET