443 Whiting Ln FNCE19-0097 FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
FNCE19-0097
CITY OF ATLANTIC BEACH
�~
800 SEMINOLE ROAD ISSUED: 8/16/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 2/12/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL !RK MUST CONFORM T• THE CURRENT 6TH EDITION1 OF • 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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
443 WHITING LN FENCE WALL OR BARRIER FENCE FENCE $2400.00
TYPE OF
ZONING: :D •
• • GROUP:
171438 0000 ROYAL PALMS UNIT
02A3.00
COMPANY: ADDRESS:
COAST TO COAST FENCE 1221 GALAPAGOS AVE S JACKSONVILLE FL 32233
CO
• ADDRESS:
BRADLEY CLYDE W JR 443 WHITING LN ATLANTIC BEACH FL 32233-3912
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.
1 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
2 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.
Issued Date. 8/16/2019 1 of 2
< FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
r -
CITY OF ATLANTIC BEACH FNCE19-0097
800 SEMINOLE ROAD ISSUED: 8/16/2019EXPIRES: 2/12/2020
ATLANTIC BEACH. FL 32233
3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
4 PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
5 PUBLIC WORKS FENCING REMOVED INFORMATIONAL
Notes:
All old fencing and debris must be removed from job site by Contractor.
6 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PLAN CHECK 455-0000-322-1001 0 $17.50
FENCE 455-0000-322-1000 0 $35.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $81.50
Issued Date:8/16/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road —
s� Atlantic Beach, Florida 32233-5445 _0 0
s
Phone(904)247-5826 • Fax(904)247-5845
CJs! )r E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 44S W L4 i ri10e Department review required Ye No
Applicant: C c� ( tC ) {��( P mg &Zoning
Tree Administrator
Project: c or s
drublic Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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: Q pproved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
(EL DIN
PLANNING &ZONING g .�y
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
Building Permit Application OFFICE COPY Updated 10/9/18
City of Atlantic Beach Building Department "ALL INFORMATION
y 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
vu��
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 447 5 WNW 1 D AJC—L A 06 Permit Number: I—NCK 0097
Legal Description RE#
Valuation of Work(Replacement Cost)$ Z�m Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ❑Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No
• Will trees be removed in association with proposed roiect? ❑Yes must submit separate Tree Re oval Permit ❑No
Describe 0 detail the type of work to be
3Z� LC,k perford: 1/9 OQ pard Ove• boa,0( CC'
+ CA&
Florida Product Approval# for multiple products use product approval form
Propertv Owner N Information 11 J-i/'#,/
Name &L'o e4pco Address 4/J ii /Tl^J C_ 6/4 A/e _
City TI C- &&ff State r-(- Zip ,yz ZZ Z Phone gOL/ YZ /wiv,
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company (L41 -MCQPS- �CO, —QualifyirIgAgent TOIJ PYP4215 T
Address l N1 G-A L+4 f AQ)S A L45 ✓� City V1 LCe State Zip 3 ZZ3 3
Office Phone fdq_ q q(.13(� Job Site Contact Number Q0%/ 7p$ ]785
State Certification/Registration# E-MailUJ �i
Architect Name&Phone# •. �'
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt Expiration Date `Y ! -� Z
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or instal I in4ar O
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regLEting Z p
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construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIQ_4P O Q
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requiremen9d10hA U O
permit,there may be additional restrictions applicable to this property that may be found in the public records of this couA, do A C
there may be additional permits required from other governmental entities such as water management districts,state aged oO Q
federal agencies. Uu'
Ir- W �
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance wiigant W
applicable laws regulating construction and zoning. 0 IM W W
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT M >" a � m
f- wp w
V
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.IF YOU INENDF0 LU w
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE LLA w
cc
RECORDING YOUR NOTICE OF OMMENCEMENT.
(Signature of Owner or Agent) (Signature of Contractor)
Si ed and sworn to(or affirmed)before me this day of Sined and sworn to(or affirmed)before me this�ay of
��sc-, a a o
Nolan PuO�ic State of of Notary)
Roberta,[0))Carlisle Signature of Notary) (Signature y)
�' ��, �p• My Commission GG 251658
6• Expires09/15/2D22
arsY Notary Public State of Flonda
r o a n [J]Personally Known OR1PRoberld D Carlisle
[ ]Produced Identification [ ]Produced Identification `�Y"d;
My Commission GG 251658
Type of Identification: Type of Identification: "+ Expires 09115/2022
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-- -------------
City of Atlantic Beach APPLICATION NUMBER
os �� Building Department (To be assigned by the Building Department.)
800 Seminole Road (7
{' 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://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 44S Wi:Airauc Department review required Yes No
i
Applicant: c'-� y ��S P)a nmg &Zoning
C') Tree Administrator
Project:
blic 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. []Denied. []Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by;::�� Date: r
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 5/1 912 01 7
rs'`Ly'J� City of Atlantic Beachs..� IV APPLICATION NUMBER
To be assigned b the Building Department.)
Building Department ( 9 y g
800 Seminole Road AUG U 6 2019 1 q —0c) l 7
Atlantic Beach, Florida 32233-544,5
Phone(904)247-5826 • Fax(9041:447-5845 y!,Z
E-mail: building-dept@coab.us xe: Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 44S �/1-4( 1:11ULDepartment review required Yes No
� i �
Applicant: 0_0 8SE lu ') P) ning &Zoning
Tree Administrator
Project: C� c or s
lic 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: Approved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed b4y 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
"At /r'.,. REVOCABLE ENCROACHMENT AGREEMENT
nl 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
Is&EJ T;04-b LP/ 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 e;:--F",Jc
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 �6&3 40/1/7-/A/G ZXAl
• 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.
T Date
Property Owner/ gent(si ed in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DU�VAL
The foregoing instrume s ac ed this��day of 120 ,
by who personally appeared before me and
(pri ted nam Si r)
ackn edged tha he a gned the i trument voluntarily for the purpose expressed in it.
Department Approval:
S;e—rsonally
atu -of Notary Public,S ate of FI Ida N IGf7oINNDLESPERGER
4'` MY COMMISSION#FF 924951
Known �` EXPIRES:October 6,2019
[ ] Produced Identification(Type) Bonded ThruNotMnPublic undewnters Scott Williams, Public Works Director
H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18 1A4
TS�L'y City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road //� p
Atlantic Beach, Florida 32233-5445 ^I�i�.�I — D (7
V
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us 11
APPLICATION REVIEW AND TRACKING FORM
Property Address: 44S �/141r/,VjL Department review required Yes No
miffi
Applicant: �L) �( a')&Sz P)a ping &Zonings
Tree Administrator
Project:
ublic 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: []Approved. []Denied. MNot applicable
(Circle one.) Comments:
BUILDING p '7
PLANNING &ZONING Reviewed by: Date: O
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