1345 Ocean Blvd DWAY19-0026 Pavers PERMIT NUMBER
DRIVEWAY PERMIT
DWAY19-0026
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 8/12/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 2/8/2020
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.
_r VALUE OF WORK:
JOB ADDRESS: PERMIT TYPE: DESCRIPTION:
1345 OCEAN BLVD DRIVEWAY SINGLE OR TWO remove & replace pavers for $3000.00
FAMILY DRIVEWAY parking
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1718410010 MANDALAY
COMPANY:-- ADDRESS: CITY: STAT E
CITY-STONE, INC 9339 CRAVEN ROAD JACKSONVILLE FL 32257
OWNER: ADDRESS: CITY: STATE: zip.
SCHWORER TRUST 1345 OCEAN BLVD ATLANTIC BEACH FL 3 2 2)
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.
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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: 8/12/2019 1 of 2
DRIVEWAY PERMIT PERMIT NUMBER
DWAY19-0026
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 8/12/2019
Uji 9 ATLANTIC BEACH. FL 32233 EXPIRES: 2/8/2020
3 PUBLIC WORKS ROLL OFF CONTAINER F 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.
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 REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
8 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL
Notes:
No extra or additional work can be done without a Revision to permit.
9 PUBLICWORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking and debris must be removed from job site by Contractor.
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 $100.00
TOTAL: $125.00
Issued Date:8/12/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
ip W
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826- Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://vvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: C)(_ Department review required Yes No
Building___._ _
Applicant: a nn'ing &Zo
A—A- ��g
Tree d�minis ra ff®r
_15'=blic Zork
Project: L-PA W 4 It�4 S S_7�)
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date A,
of Permit Verified By Vb L
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: OlDenied. E]Not applicable
(Circle one.) Comments: /oApproved.
BUILDING
PLANNING&ZONINGA,,it Reviewed by-"e��� Date:'?-3o-t n�__
TREE ADMIN. Second Review:. ElApproved as revised. F]Denied. F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [:]Approved as revised. DIDenied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
City of Atlantic Beach F-CEIVIE APPLICATION NUMBER
Building Department JUL 3 0 2019 (To be assigned by the Build-ing Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 L Date ro
E-mail: building-dept@coab.us uted:
Cityweb-site: hftp://vvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: y aeavi 6 dj Department review required Yes No
Building
Applicant: Planning &Zonin�g �
Tree Adrn_in_isf_raTo_f
L tit r
Project: Public Wo ks
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: VApproved. ElDenied. E]Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by� Date:'.0,;1�:1W
TREE ADMIN. Second Review: ElApproved as revised. F]Denied. F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by.- Date:
FIRE SERVICES Third Review: DApproved as revised. ElDenied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
v
j
v
Building Permit Application Updoted 10/9/18
city of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address:_/ ,3q5 Oerz-YMv 0) V9 Permit Number: DW A tcf -
Legal Description 1P6y51Q_S RE#
Valuation of Work(Replacement Cost)$,:5000 Heated/Cooled SIF ql�-�+Iea
Class of Work: E]New ElAddition )61teration EIRepair ElMove E]Demo iOPbUl E]Window/Door
Use of existing/proposed structure(s): OCommercial DResidential
J U L 2 6 2019
• If an existing structure,is a fire sprinkler system installed?: Dyes E]No
• Will tree(s) be removed in association with proposed proiect? E]Yes(must submit sepzitate-TFCe-R��-rii-6��Tpi��itliI Ello
Ees;ibe in detail the type of work to be performed: Rc-ovtle 1F)0.57_/A)C-
F
62 d- CM<-
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name 0o U&k As :5 G H wo tZea Address /.;3L/5 ve�e^,J & 09
city State ie'�, zip -3;?,,2 33 Phone WIt - q.2-3 - 3.2
E-Mail
Owner or Agent(if Agent, Power of Attorney or Agency Letter Required)
Contractor Information
NameofCompany OMTIV111,16 ,11%1c, QualifyingAgent
Address 433 7<2 city -_W,&1Sty0V1L1J--,tate 64 zip 3 7
_T Py- 1?"?5 - YA�v Job Site Contact Num�P4 W11-75'Y-01179 C&Z2-
Office Phone
State Certification/Registration# E-M a i I
Architect Name&Phone#
Engineer's Name&Phone#
*orkers Compensation Insurer OR Exempt 0 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. 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
RECORDIDY YOPR NOT EOF COMMENCEMENT.
(Signature of Owner or Agent) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this Q�I'Oday of ned and sworn to(.or affirmqd)be —p-t of
-7,by �IWCF4 WOtb, Z69"LMk
_JxAAq% k by 0011i ll�4 L)f PL f �g
_�fl\lotary) a1upe
o/Notary)
TONI UNDLES; ERGF
JENNIFER J - FF
OHNSTON ��ISSION
A
'id -knol
MYCOMMISSfo
Personally Kno N#GG 042984 1 ly, vfFQ�:S,,ct 2019
7--., EXPIRES:October 27.2020 5tibWtBry Publ. UroerwOte
kj.Pv6duced Identitic 0 B,onded T Notal P= I I Wr6dTc.�FfdeTitffid
ters Ty P�-6f I
Type of Identification: (Iml
-A.-
REVOCABLE ENCROACHMENT AGREEMENT **ALL INFORMATION
City of Atlantic Beach
HIGHLIGHTED IN GRAY
800 Seminole Road,Atlantic Beach,FL 32233 IS REQUIRED.
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
of Atlantic Beach, Florida, hereinafter
referred to as "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 P1 VVZ5 —, I I PIE ?h V941 t-�
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted 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 1315r &M , AT rla6C.,4—
LAA)
• 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 hereby assumed by the USER.
Date 61</,0
Prop&ty,Owner/Agent (signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this %:)L day of LA 20
by (A C--,t NAWO) L-V1 who personally appeared before me and
(printed name of Signer)
acknowledged that he/she signed the instrument vokmt in it.
JENNIFER JOHNSTON
My COMMISSION#GG 042984J
EXPIRES:October 27,2020 Department Approval:
I Un _ .
3., Bonded Thru Notary Public Underwriters
Signaftde of Notary Public, State of Florida
Personally Known
Uproduced Identification (Type) Scott Williams, Public Wor!ZsE�i�ector
H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION "ALL INFORMATION
City of Atlantic Beach HIGHLIGHTED IN GRAY IS
800 Seminole Road,Atlantic Beach, FL 32233 REQUIRED.
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
JobAddress e>6c-qA) v>c,�l -Permit Number DWM A- 002(0
Contractor Information
Company C/ly
Qualifying Agent
Address ?3 3,9 R city State k, ZiD 7
Phone E m a i I #q/_t-_5 rv/vc 4vol
State Certif ication/Regist ration#
Architect Phone Email
Engineer Phone Email
Workers Compensation Insurer OR Exempt o Expiration Date
• 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 Public Works Director,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 Public Works Director 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 W C-LI-IA16:rOny RZ C-A A)TA 0-It (Project Superintendent)
with(Company Name) 7VAJ6 I AJC- Phone qoq-751-0978'6C4&
• All materials and equipment shall be subject to inspection by the Public Works Director.
• 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 Public Works Director 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.
• The Pu ic Wor 5;DAc r shall be notified 24 hours prior to starting work and again immediately upon completion.
Date
Permit��e(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
2o
The foregoing instrument was acknowledged this C day of 3aN
by of A_� who personally appeared before me and--
(printed name of Permittee) JENNI FERJOHNSTON
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. N1 ComMISSION#GG 0429154
EXPIRES:October 27,2020
Bonded Thru NotarY Public Underwriteft
Personally Known I
Signat6�r ofW6�'tary Public,State of Florida [ul-1:1-roduced identification(Type)—Z-It.- b d L tl
H:\Applications&Forms\Word&Excel Document Originals\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18
MAP SHOUNG SURVEY OF
LOT 7, BLOCK 53, MANDALAY, S RECORDED IN PLAT BOOK 10,
PAGE 11 OF THE CURRENT PUBLIC RECORDS OF DUVAL
COUNTY. FLORIDA
NOTES:
THIS IS A BOUNDARY SURVEY.
NO BUILDING RESTRICTION LINE AS PER PLAT.
NORTH PROTRACTED FROM PLAT.
INTERIOR ANGLES AS PER FIELD SURVEY. AND
ARE LABELED THUS:
A.90*09'24!
8.8874'15'
C.91-3W23'
0.89'49'59'
LOT 5
I/rIM FFE LOT 9
FOUND.CAP 133-21''MEASURED IN FIELD)
3672 1 1/2-PON PPE
0 FOUND,NO
0 .- STOW WALK 0.2,
1-9 0.3,
0 > 490 B
ot
LOT 7
rn
X TWO STORY I'wow
1- 28.
< 12. FRAME AND
STUCCO
J4 go LOT 6
0 RESIDENCE 7S
< VOW'.
11345
F— V WOOD
> m COLUIAN
< < 28.2' 54-1 4!WOW
> 5.71
< > .0
�q 79' WOOD 110
I;rlRiA FFE—O.n
;FOUND.NO CAP ow 1/2-010N PIPE
132.0�(multm IN FIELD) FOUND.NO CPP 0.3,
LOT I LOT 2
LOT 3
SCALE- 1' 20'
THE PROPERTY SHOWN HEREON
APPEARS TO LIE IN FLOOD ZONE "X"
(AREA OUTSIDE 0.2% ANNUAL CHANCE THIS SURVEY WAS MADE FOR THE BENEFIT OF
FLOODPLAIN)AS WELL AS CAN BE LINDLEY TOLBERT DESIGN.
DETERMINED FROM THE FLOOD
INSURANCE RATE MAP 12031CO409H,
REVISED JUNE 3, 2013. FOR DUVAL
COUNTY, FLORIDA.
"NOT VAUD VATHOUT THE SIGNATURE AND DONN W. BOATWRIGHT. P.S.M.
THE ORIGINAL RAISED SEAL OF A FLORIDA FLORIDA 1-1111 SURVEYOR and MAPPER No. LS 3295
LICENSED SURVEYOR AND MAPPER.' FLORIDA LIC. SURVEYING&MAPPING BUSINESS No. LB 3672
CHECKED BY.- DATE:
DRAWN BY. CL BOATWRIGHT LAND SURVEYORS, INC. JUNE 19, 2013
FILE. 2013-0519 1500 ROBERTS DRIVE, JACKSONVIIULE BEACH, FLORIDA 241-8550 SHEET 1 OF
5 - 9 tio
qr pi
*0't 1
r
a. 9'
I
000
vg
n�CRcTIE (+0'17 1r! �3 #V �.D�'�i►
OCEAN BOULEVARD
( FORMERLY M ANDALAY AVE. )
50" RIGHT OP WAY
PACS
_ ---------- _
a
69
NOTICE OF COMMENCEMENT
State of zz,6-f Tax Folio No. / 7
Countyof Ozza,4z
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713
of the Florida Statutes,the following information is stated in NOTICE OF COMMENCEMENT
Legal Description of property being improved: A 4,
P/r7 7-1e-R-e-le A-7 PZA //j
44 fl,
- 0 �J
s 0 f�06`p e q�4n g1l M�I'p qro-v : -� 5
General description of improvements: SEL)V �A yc)4�;,
Owner: Poo&z-�t -s�WvR&R Address: qS (D A-1 16
Owner's interest in site of the improvement: 6��Iv�o<
Fee Simple Titleholder(if other than owner):
Name:
Contractor:
Address:
Telephone No.: Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may
be served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Doc#2019175065,OR BK 18879 Page 332, SignedK.— Date:
Number Pages:1 Before me this zu day of C1 in the County of Duval,State
Recorded 07/26/2019 03:07 PM, Of Florida,has personally appeared U
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Notary Publi t L St e Flo
mycommissica aM' C-G�ly o
c
COUNTY n e.pires: JENNIFER JOHNSTON
RECORDING $10-00 Personally Known: My COMMISSION#GG 04,VS4
EPTRES,October 27,2020
Produced Identification: 6",
I—I I a u"nory ruplic unde—rvorijers