Loading...
1810 Selva Grande Dr DWAY19-0023 Paver DRIVEWAY PERMIT PERMIT NUMBER it, CITY OF ATLANTIC BEACH DWAY19-0023 ISSUED: 8/9/2019 800 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 EXPIRES: 2/5/2020 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' ! BUILDING • ! • ! CITY OF • NTIC 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. JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: DRIVEWAY SINGLE OR TWO REPLACE DRIVEWAY WITH 1810 SELVA GRANDE DR PAVERS ADD PAVER $8600.00 FAMILY DRIVEWAY SIDEWALK & PATIO TYPE OF BUILDING • • GROUP: 169542 5004 SELVA TIERRA COMPANY: ADDRESS: • ADDRESS: CARPER RICKY L 1810 SELVA GRANDE DR ATLANTIC BEACH FL 32233-4526 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. 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 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:8/9/2019 1 of 2 DRIVEWAY PERMIT PERMIT NUMBER DWAY19-0023 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 8/9/2019 x� 9 ATLANTIC BEACH. FL 32233 EXPIRES: 2/5/2020 3 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. 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 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 TOTAL:$25.00 Issued Date:8/9/2019 2 of 2 YiyLy 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) i E-mail: building-dept@coab.us JUL 2 2 zwk- Date routed: 1 City web-site: http://vmw.coab.us i I I - APPLICATION REVIEW AND TRACKING FORM Property Address: KDI 1SCL-\f_A Q�PA_10Department review required Yes No Applicant: OUID(\,D C--YL--.) n &Zoning Tree minis ra or Project: F— &CQ, _C:fublic Works Public Utilities F('UC--(z— b&-ouL Cc ©�- �� 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: V-pproved. ❑Denied. []Not applicable (Circle one.) Comments: BUILDING c PLANNING &ZONING Reviewed by. Date: 2 .� 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 0 511 9/2 01 7 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road n 7 Atlantic Beach, Florida 32233-5445 Ct Phone(904)247-5826 • Fax(904)247-5845 tt E-mail: building-dept@coab.us Date routed: 1 City web-site: hftp://www.coab.us 11 APPLICATION REVIEW AND TRACKING FORM Property Address: Cbl 0 Se'L_VA Department review required Yes No Applicant: n &Zoning Tree minis or Project: Public Utilities pf,U eiz- 0&-Qu cc.. Q, t©�— � 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: proved. []Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING _Zs^_ c1 Reviewed by: Date: 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 05/19/2017 Updated l0/9/18 Building Permit Application J t~, City of Atlantic Beach Building Department "ALL INFORMATION � V 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY IS REQUIRED. Phone: (904/) 247-5826 Email: Building-/Dept@coab.us l o /� Job Address: L �� !ll�- lrti-G- -�C.�'2_ i/ii. Permit Number:� 7� '�V c)7,:5 Legal Description / RE# Valuation of Work(Replacement Cost)$ v2p Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition IAAlteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial O(Residential • If an existing structure,is a fire sprinkler system installed?: Dyes T(No • Will trees be removed in association with proposed roeect?❑Yes must submit separate Tree Removal Permit o Describe in detail the type of work to be performed: /CeeJ&(Q CCr�Ye �1^l VQ sa a-1 Z Pc-u4h deco. }- s e &.,a-Nk Florida Product Approval# for multiple products use product approval form Propertv Owner Information �^ Name �t �_ ���e Address /Plo J001- &YcL)4e -)/t. City C �, 1 C i eA cl 1 State Zip '72- Phone `79)V - l r E-Mail yo47-CcJCr6J 77 140. col-h. Owner or Agent(If Agent, Power of Attorne or Agency Letter Required) Contractor Information Name of pan M / fL O � £�S , �� Qualifying Agent Address co4U. 1"dX 1J r67 City J 4dt5 tl.11/le State_1 Zip `3 22 Y-57 _ Office Phone Y 4Y' ' ;Z 37 Job Site Contact Number State Certification/Registration# E-Mail Architect Name&Phone# Engineer's Name&Phone# 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. 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 INTEN TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECOR91+11YOl�R NOTICE OF COMMENCEMENT. r ignat re of Owner or Agent) (Signature of C ractor) S n d nd sworn�,t�o�( rr affir befor me s 6 of Signed and sworn to(or affi ed)before me this day of (Signatur tary) (Signature of Notary) ' ry [ ]Personally K own OR ]Personally Kn�tkt ;; iMNIGINDLESPERGER [ ]Produced Ide, 'fc ri'`_- i1 YC0AdMI�SIONtlFF92G951 [ ]Produced Identification " EXPIRES:October 6,2619 Type of Identification: Type of Identific rQL *,` rru a u is rderxrers 5 N ..+..rzv:..,am'a1.aw:.�.a.a rty%1Jy , Owner Builder Affidavit **HIGHLIALL HIGHLIGHTED IN HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. l fl r 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.uS PERMIT#: I. FLORIDA STATUTES;CHAPTER 489, FLORIDA STATUTES, PART 1"CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED 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. YOU MAY BUILD OR IMPROVE A ONE OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR.YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. II. INJURY LIABILITY;SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. . 111. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO$5,000 PENALTY UNDER FLORIDA STATUTE NO.455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR THE FLORIDA"CONTRACTORS CERTIFICATE"TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904- 247-5826 OR BUILDING-DEPT@COAB.US) IF IN 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. Job Address: 4-10 /�� )U6.- �<-- //�� y' c Owner Name: /�-/ r- ky ` - C�rcK Phone Number: Mailing Address: O ,S!2 IUA City: &J— State: _Zip: Notarized Signature of Owner Thef re ing instr ent was acknowledged before me this qday of 20 in the State of Florida, County of Signature of Notary Public Personally Known OR [ ] Produced Identification Type of Identification: TONi GINDLESPERCER i MY COMMISSION#FF 924951 _ EXPIRES:October 6,2019 Updated 10124/18 ;i F? Bended Thu Nctary Pubk UGde itcf�I, 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 V Q Job Address /�/ �`=1 u l� ����: Permit Number DWAI 1q-0023 Contractor Information Company /V n�X£L6 � �' /�'C Qualifying Agent Address ®� t� 7 city State /—� zip �� S Phone /U 7 ' it 7� Email State Certification/Registration# Architect Phone Email Engineer K'`T Phone Email Workers Compensation Insurer OR Exempt❑ 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 (Project Superintendent) with(Company Name) A"W�a /o 4VVT Phone �FOV — - .2,�2 7? • 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 P,ubl e Workgirector shall be notified 24 hours prior to starting work and again immediately upon com letion. Date Permittee(sig�e4,i present f Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL The fo g irk&instrument wgsNcknowledged this day of 20 by V�jwho personally appeared before me and ged nam of rmittee) acknow ed that h he instru ent voluntarily for the purpose expressed in it. TOM G,NDLESPEgGER MY COMMISSION#FF 92.49-1 �ersonaEXPIRES:October 6,2019 Po dad Tnr Notary Public Undera0er. Signature•f Notary Public,State of Florida [ )Producelld' t € H:\Applications&Forms\Word&Excel Document Originals\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18 REVOCABLE ENCROACHMENT AGREEMENT i, City of Atlantic Beach **ALL INFORMATION 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 existinad r the laws of the State of Florida, hereinafter referred to as "CITY" and C Z L Cof 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 /QQ/'/US CX97 7z; IOM64-6t �G 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 /1P-/6 -5-1 cC Y9 < ✓Ir— pjya „kl, 41 001 • 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 liabil' es'are hereby assumed by the USER. Date 7/ Property OwnerAgent (signed in presence of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL r / The foregoing instrument was acknowledged this 19�day of l ,20 l Dby R �_ who personally appeared before me and (pri)ed name of Si ner) ackno I ged th e/ signe the instrument voluntarily for the purpose expressed in it. Department Approval: Signature of Notary Public,State of Flort r ` ; o�'a`-y TONT GIN0,ES}'E9Gi'R vl" • [ ersonally Known MYCOMNSSIC4WFJ2S9.51 . EXPIRES:October 6,201.E ' a' Scott Illiams,P c orks Director [ ] Produced Identification(Type) F� enrmedrrn,Noxnauy;,cu:dF.v;; , H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18 / I 1 � a3AOHO'd 6-L3 73� � 01 ❑ _ ll i it I Iii A-DM?1(DM VD �� I "LT o •G/, 7jN &J0dlo lob Jd Z. 7 VaW 3LYLS or -M v0 213ddY11 80A-3i Slo wd Mo4w uwo w ati fir¢, 3 vAY mno :vA c)2 =� 1 rnAM�a VM A4 **I* 'ON sTd :4003 '0 AXNY7 lrocm t» � s+,wn�sr x�nrs •rra saLfttv19 VOWU YSO'zl* Nnu03S aL INVnsand SX3ddYM oNY sya 3i&nS 7VNOISS-:WLId-40 GYY08 MV1S VOWV 3H1 A9 141410-413S SONYONVIS 7VOINHO3L MnMINIM 31.11 SIMM hW3 GH (srtr n!m�r t7U NMOHS A34YnS 3HL IM ONY NMOHS SV 1d3OX3 SLN3IYHOVOd(ON3 iW ADM ON 3YY 369HL IVM INOU031110 ONY NOISA1 Gdf)S 37181SNOdS AM a„�■ AM bGGNn 03d3iHnS 3X314 SONY?3A08Y 3H1 IVH1 A-AUM A93WH I OtMY7 star-lf-1 (COs) 99Z.f bo1YO-U 3714Nosxodr L# mins Aym smoov3nude cc*a *JA `scYoA9A(Yns QMV7 ZLVss I9L 3MlVS iV NOILYO.U&M Y 31nLILSAW ION S3100 CNV A7N0 AM&no0 V SY I i`C St Lola ONV Lo _L-1--17 031 Yo vow-u �--3,Q ' Aiio 3141 Yo-41555 dYIY 31Y21.?Jwafnsw 000u /117X-4 O37YOS SY `; 3NOZ OXVZVH 01007-4 N/HtN 317 01 SYV3ddV Nt73XGH NHOHS Al2L3doyd 3Hi WOHS SV 3Nn NO 03SY8 S-ONPW38 oms1 GaNn 3HL do 7Y3S Him 03SS08/Y3 SS37Nn 017YA 1L �I•oo1 ot " ,: _" : . Ldp{` 9• � 3��,3 s,r��?,+3�' 2% 4 took /J-S - 2 WCb C ,( _ O v o� N N z� v� �•E ' ' • 'Y R Ar y •o-) .��,�--�-�21-vn n ?-ity 1'ZJ-O Y�33• CJ"d-?�"�'x2p'V� 7 �2J x?'•1 V V S,.L 121�y r--�'�Sl r-•o,i-ary v-z�J�/� �iro� -�a v'� •-�1 ;�'�o(� i •-� c T-x,`21 410_4 03&LLY30 volyo-z-4 :uxnoo 7YAnO-4o Soux-;y onBnd 3Hl dO�yg Z-g2 s Yd Cam h1o081Y7d NI 0301LDO3y SY JO dVW NO ATAInN.0 CY __ x)nTu rfnrr tC ctFgR arc MFIED FOR: A-j E CEIVED s I-j 00,0&' ty o! Atlantic 3milding and Z ing Existing pool with spa LL ed into sun shelf LL 0 CID 'jo-"I'll, 0 15.5 % yc 40 W AX No Gdd 16,%a v.,a,4 j -r&,rAccs L,;I/ 6t addeA t.