1505 Jordan St DWAY19-0024 Replace Driveway w/Concrete bli-P DRIVEWAY PERMIT PERMIT NUMBER
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DWAY19-0024
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 7/30/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 1/26/2020
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 OF ORDINANCES .
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1505 JORDAN ST DRIVEWAY SINGLE OR TWO replace driveway with $2500.00
FAMILY DRIVEWAY concrete
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
NUMBER: GROUP:
CONSTRUCTION: i
1722960010 ED SMITH S/D
COMPANY: ADDRESS: CITY: STATE: ZIP:
A & B Asphalt Repair Inc. 700-39 E. Union St. Jacksonville FL 32206
ADDRESS: CITY: STATE: ZIP:
MILLER SHARON P 1505 JORDAN ST ATLANTIC BEACH FIL 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 container company must be on City approved list . Container cannot be placed on City right-of-way.
PUBLIC WORKS DRIVEWAY APRON INFORMATIONAL
Notes:
All concrete driveway aprons must be 5 inches thick,4000 psi,with fibermesh from edge of pavement to the property line. Reinforcing rods or mesh
are not allowed in the right-of-way.
PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL
2
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.
Issued Date: 7/30/2019 1 of 2
DRIVEWAY PERMIT PERMIT NUMBER
DWAY19-0024
CITY OF ATLANTIC BEACH
ISSUED: 7/30/2019
800 SEMINOLE ROAD
m ATLANTIC BEACH. FL 32233 EXPIRES: 1/26/2020
3 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
4 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.
5 1 PUBLIC WCRKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
6 PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
7 PUBLIC WORKS MAXIMUM DRIVEWAY INFORMATIONAL
Notes:
Maximum driveway width within the City right-of-way is 20 feet.
8 PUBLIC WORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking debris must be removed from job site by Contractor.
9 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
ZONING REVIEW MULTIFAMILY USES PER DWELLING UNIT 001-0000-329-1003 0 5100.00
TOTAL: $125.00
Issued Date:7/30/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Daterouted:
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ILYAD-fy Department review required Yes No
BuildiQg
Applicant: �_F�Ianning &Zonind��
Tree AdffiihTs1l`af67r
C Public Works-'-,
Project:
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: "'�Pproved. F]Denied. E]Not applicable
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed by:'Oo�� Date: 7-2 6-
TREE ADMIN. Second Review: []Approved as revised. []Denied. [-]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
City of Atlantic Beach APPLICATION NUMBER
V t� ' -
(To be assigned by the Building Department.)
Building Department
800 Seminole Road
P Atlantic Beach, Florida 32233-5445 till,
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us
6 1 Date routed:
City web-site: hftp://www.coab.us i*--
APPLICATION REVIEW AND TRACKING FORM
Property Address' IDS- JWAP-a t Department review required Yes No
B
Applicant: _A A-;:s6&_W Planning & oning
"9 Tree AdminiffraTqf
Project: (3 LPublic Wo��
J A P u lohl i_C-0-ti Mi e_s
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. OlDenied. []Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by Date: X'_2
TREE ADMIN. Second Review: E]Approved as revised. F]Denied. []Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F]Approved as revised. DDenied. [:]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Building Permit Application Updated 1019118
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Build ing-Dept@coa b.us IS REQUIRED.
Job Address: 15V 5' 0-0-- 'O'n 5 ,t Allf n A Permit Number: A\1 M-oo�(-t
W 1%ry
Legal DescriptionV 5mtJA -Slo Al /a t I ZerD 2k 1,02,?R-z4 REtt
'r ffZ1t_A
Valuation of Work(Replacement Cost) Heated/Cooled SIF n
• ClassofWork: EINew ElAddition ElAlteration Ml�epair ElMove E]Demo E1Po inclow/Door
• Use of existing/proposed structure(s): OCommercial R;RLS-sidential JUL 2 4 2019
• If an existing structure,is a fire sprinkler system installed?: ElYes EINo
• Will tree(s)be removed in association with proposed proiect? F-]Yes(must submit se r te mova Permit) PNo
I
L
cribe in detail the type of work to be performed: I I
A01014f 4f Al e-xi 7Z/ 6,b f7e
F
Florida Product Approval 4___ for multiple products use product approval form
Property Owner Information
Name 5-hqev oi F M.-I/e,,- Address no Sle C,r—
city A-A Ignt-"c. 8c 4 c.11 State F1, Zip ZA-PLY-3 _11hom, 'I L5,--L -- 1-i -)r 3 v
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company #4 A 5,PA t Qualifying Agent 4?-t&fC Abh660,L-
Address City —Ri-k
4ajy&,&2/c-State J1C7/, zip
Office Phone TOO :ry_J_ 17 773 Job Site Contact umber 1Qq-,C_ +A �&-A0,-
State Certification/Registration# E-Mail. dael 4'�e At/7Ler^r.C_do.1"
Architect Name&Phone#
Engineer's Name&Phone#
Workers 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 coun ty, 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 IMPROVEMEN�Tg'fO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LEN ERORANATTORNEY BEFORE
WOSICEncjOMMENCEMENT.
(Signature of Owner or Agent) (Signature of Contractor)
04
-9 .9 or affirmed)before me this day of c1ndsl affir bv if r e nt bis day of
112R, and sworn to 11
1 -9 -on . U NA oA01%by.T�
9_01t4 by Svw M n 110(
In'K am A
i r%/1 1' 1. . 61.
(SignatL�re of Notary) (�ig'n`alur�of�;t
�,OTA
CO My Comm. xpi es U)
June 28,2022
[ I sonally Known OR ]Personally Known OR F,
oduced IdentificaUon [W'frodced Identification
omm. G 233661
of Identification: Type of Identification; 1130
OF F
REVOCABLE ENCROACHMENT AGREEMENT
City of Atlantic Beach "ALL INFORMATION
800 Seminole Road,Atlantic Beach,FL 32233 HIGHLIGHTED IN GRAY
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
5Aq,d,A R 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 &;pArli- Pee r-
Any facility maintained, repaired, erected, and/or installed in the exercise off 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 /570 5— J'V--do'n 5y A4,7t,�C- 9,e4, -?;t-XI-7 -
• 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 an( of the work herein under the terms of this permit and that all of said
liabilities are hereby assu 5
7JI19�L Date /C1
Property Owner/Agent (signed in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this day of 120
by �JatI[Cf-\ T). aiNlipC who personally appeared before me and
(printed name of Signer)
acknowl dged t she signed the instrument voluntarily for the purpose expressed in it.
Pbbw=Sknmoa
Notwy Pub9c
Stdo of FWM Department Approval:
Signature of Notary Public,State of Florida my Ca"111111161M&Pk"
Personally Known Fdwuwy 15.2C121 —/ - - -
ZZ7-
Produced Identification (Type) 'D(:\fer5 Cerise ' Scott WiTEaPms—, Publ0�®rks D�irector
H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
MAP SHOWNG SURVEY OF
A PART OF LOT 1, BLOCK 2, ED SMITH SUBDIVISION AS RECORDED IN PLAT BOOK 26, PAGE 50 OF THE CURRENT
PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA, BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS:
FOR A POINT OF REFERENCE, COMMENCE AT THE SOUTHEAST CORNER OF LOT 1, BLOCK 2, ED SMITH
SUBDIVISION; THENCE NORTH 01500" WEST ALONG THE WEST LINE OF LOT 1, A DISTANCE OF 53.33 FEET TO A
POINT ON THE NORTH LINE OF PARCEL No. 172296-0000, AND THE POINT OF BEGINNING; THENCE CONTINUE
NORTH 0*15'00" WEST ALONG THE WEST LINE OF LOT 1, A DISTANCE OF 20.66 FEET TO A POINT ON THE SOUTH
LINE OF PARCEL No. 172296-0030; THENCE NORTH 89*36'00* EAST ALONG THE SOUTH LINE OF SAID PARCEL
No. 172296-0030, A DISTANCE OF 100.00 FEET TO A POINT ON THE EAST LINE OF LOT 1; THENCE SOUTH
01500" WEST ALONG THE EAST LINE OF LOT 1, A DISTANCE OF 20.66 FEET TO A POINT ON THE NORTH LINE OF
SAID PARCEL No. 172296-0000; THENCE SOUTH 89*36'00" WEST ALONG THE NORTH LINE OF SAID PARCEL No.
172296-0000. A DISTANCE OF 100.00 FEET TO THE POINT OF BEGINNING.
0
LOT 2
2&r
PART OF LOT 2
PARCEL 172296-0040
LOT 13
q
c-
0
0) PART OF LOTS 1 AND 2 ij LOT 2
PARCEL 172296-DO30
> FOLM 1/2-RON
Z PFE.so CAP
> 1.9s EASnY&Y p LOT I FOUND 1/2-IRON
-2 Z r-�89*36'00"E 100.00 PNIF-NO CAP I Lf)
0 -0 0 PART OF LOT 1 0
n ;0 Ln 0
9g" -- 2 STORY IN) 0 P
I ;;.0 Q
CONCAM omw p -Q --L-'
�BRICK a
Ll in (;! !,,-t
m 56 m a) 0 TOWNHOUSE' 0) 0 M Ca
0z" . 0 No. 1505 - 0
m 0 3 51.3, L
b, - FOLMD 112 IRON
1289* 6'00"W 100-00' PIM NO CAP I m
) 00'W 99.91' FIELD) I
S892
POINT OF 2-
PM NO CAP PART OF LOT I
BEGINNING z PARCEL 172296-0000
LOT 14
Ci
PART OF LOT I
�w PARCEL 172296-0020
POINT OF 26.'r
REFERENCE
NOTES:
1, THIS IS A BOUNDARY
SURVEY. DONNER
2. BEARINGS ARE BASED ON S ROAD
THE NORTH LINE OF PARCEL 40' RIGHT OF WA y
172296-0000, BEING NORTH
89'36'00" EAST, AS PER PAVED
OFIFICAL RECORDS BOOK
15731, PAGE 933,
3. NO BUILDING RESTRICTION
LINES PER PLAT.
1 0
SCALE: 1' 20*
THE PROPERTY SHOWN HEREON APPEARS TO
LIE IN FLOOD ZONE *X" (AREA OUTSIDE OF
THE 0.2% ANNUAL CHANCE FLOODPLAIN) AS THIS SURVEY WAS MADE FOR THE BENEFIT
WELL AS CAN BE DETERMINED FROM THE OF SHARON P. MILLER; ALLISON W.
FLOOD INSURANCE RATE MAP No. FORSYTH; F(ATHAWAY & REYNOLDS, P.A.:
12031CO408H, REVISED JUNE 3, 2013 FOR CHICr T1 URANCE.COMPANY.
DUVAL COUNTY, FLORIDA.
'NOT VAUD VATHOUT THE SIGNATURE AND DONN W. BOATWRIGHT, P.S.M.
THE ORIGINAL RAISED SEAL OF A FLORIDA FLORIDA L11C. SURVEYOR and MAPPER No. LS 3295
LICENSED SURVEYOR AND MAPPER." FLORIDA LIC. SURVEYING & MAPPING BUSINESS No. LB -M72
CHECXIED BY: DAM
DRAM BY: CL BOATWRIGHT LAND SURVEYORS, INC. OCTOBER 29, 2014
FILE: 2014-1197 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 241-85.50 SHMT 1 OF 1 1