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2329 Barefoot Tr ACC19-0040 Paver Dway, Sidewalk, Patio '''`% ACCESSORY PERMIT PERMIT NUMBER ` ACC19-0040 CITY OF ATLANTIC BEACH ~ ISSUED: _ 800 SEMINOLE ROAD ISSUED: 8/23/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 2/19/2020 MUST CALL INSPECTION • i 914 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORMTO THE CURRENTEDITION 1 OF • ' !A BUILDING CODE, NEC, IPMC, AND CITY OF BEACH CODEOF ORDINANCES . ALL • ! • OF PERMIT APPLY, PLEASE READ 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: 2329 BAREFOOT TRACE ACCESSORY SINGLE OR TWO PAVER DRIVEWAY, $10000.00 FAMILY ACCESSORY SIDEWALK & PATIO TYPE OF ZONING: : ! • • • GROUP: 169463 0618 OCEANWALK UNIT 02 COMPANY: ADDRESS: CITY: STATE: ZIP: • ADDRESS: HOSTO MICHAEL D 2329 BAREFOOT TRCE ATLANTIC BEACH FL 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. 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:8/23/2019 1 of 2 City of Atlantic Beach APPLICATION NUMBER � r• n Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 WK 0 0ZI0 Phone(904)247-5826 - Fax(904)247-5845 s t E-mail: building-dept@coab.us Date routed: City web-site: http://vmw.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: � ZS � ( 2 Department review required Yes No �l�cL� , uildin Applicant: C)(A—) anning &Zonin Tree Administrator Project: p(� ;4 is Wor s gu is Utilities is a e y 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: :BUILDIN ,M PLANNING &ZONING Reviewed by: 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 •fr1+`ljJ City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) r ' 800 Seminole Road 0-110/1 O Atlantic Beach, Florida 32233-5445 ty �- 11 L.J"t Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: S ( � City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ZS Department review required Yes No uildin ' Applicant: (�) �C anning &Zonin Tree Administrator Project: p(ZPis Wor s u is Utilities u is aey 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: ? < <� 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 i6rsyL�� City of Atlantic Beach "$ APPLICATION NUMBER �S Building Department To be assigned by the Building Department.) ' 800 Seminole Road t MAY 16 2M * ���, " U 0z1 Q Atlantic Beach, Florida 32233-5445 J LJ V Phone(904)247-5826 - Fax(904)247-58# E-mail: building-dept@coab.us BY: Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM SvJo � De artment review re uired Yes No Property Address: z3 z9 m 1.2 p a uinin ldin Applicant: (P ..iv hC�r-. arming &Zo Tree Administrator Project: l�z P4 is wor s u is Utilities FuT is S aey C©� �-�IG, 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 te: TREE ADMIN. Second Review: []Approved as revised. Venied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY ReviewedDater FIRE SERVICES Third Review: Approved as revised. ❑Denied. ❑Not applicable Comments: c Reviewed 2 /./"A---lDate: Revised 05/19/2017 CITY OF ATLANTIC BEACH Department of Public Works 1200 Sandpiper Lane Atlantic Beach, FL 32233 (904) 247-5834 PUBLIC WORKS PLAN REVIEW COMMENTS Date: 5/17/19 Applicant: Michael & Lisa Hosto Permit#: ACC19-0040 Email: michaelhosto@gmail.com Review Status: DENIED Site Address: 2329 Barefoot Trace THIS PLAN REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS Correction Items must be submitted to the Building Department at 800 Seminole Road. Submittals that respond to only one or a few correction items will not be accepted. Revisions may not be submitted until ALL departments have completed their respective reviews. Revisions must be submitted to the Building Department and must respond to EACH department review. PUBLIC WORKS CORRECTION ITEMS: • Driveway cannot go through sidewalk. • Sidewalk must remain concrete. APPROV D PUBLIC WORKS CONDITIONS OF APPROVAL: (The following comments will be printed on your permit as Conditions of Approval) • 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. • All runoff must remain on-site during construction. • 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. • Full right-of-way restoration, including sod, is required. • Maximum driveway width within the City right-of-way is 20'. Scott Williams, Public Works Director swilliams@coab.us/904-247-5834 Resubmittal Notes: All revisions and changes shall clearly stand out from the rest of the drawing on the sheet as a revision by way of completely encircling the change with "clouding". The revision shall also be identified as to the sequence of revision by indicating a triangle with the revision sequence number within it and located adjacent to the cloud. The revision date and revision sequence number shall also be indicated in a conspicuous location in the title block for each sheet on which a revision for that sequence occurs. For projects still in the initial review stage and permit pending, all sheets with revisions shall be inserted into each set of drawings. The original sheets must be clearly marked "VOID" but are to be left within the set of drawings. Complete new sets of drawings will not be accepted. ADDITIONAL ITEMS MAY BE REQUIRED DEPENDING UPON NEW INFORMATION AND CLARITY OF FINAL PLANS SUBMITTED FOR REVIEW. Page 1 of 1 0:\Public Works\ADMIN\PLAN REVIEW COMMENTS\ACC19-0040(Owner-Hosto).docx RECEIVED CITY OF ATLANTIC BEACH MAY 2 4 2019 800 Seminole Road J Atlantic Beach, Florida 32233 r Telephone(904)247-5800 Building Department FAX(904)247-5845 City of Atlantic Beach, FL REVISION REQUEST SHEET OR CORRECTIONS TO REVIEW COMMENT Date: , / Received by: Resubmitted: Permit N ber: Original Plans Exa Project Natne: Project Address:-.Z�- `-'? TtCE-- Contractor: Contact Name: Contact Phone : - Contact e-mail: Revision/Plan Check/Permit Fee (s) Due: $ Description of Proposed Revision to Existing Permit: Additional Increase in Building Value: $ Additional S.F. Site Plan Revised: Public W/U Approval: By signing below. I (print name) affirm that the above revision is inclusive of the proposed changes. Signature of Contractor/Agent (contractor must sign it increase in%aluviun) Date Office tlse Only Date: Approved: Rejected: Notified by: _________ Plan Review Comments: 6 Department review required Yes No . Building --- Planning&Zoning Tree Administrator V SI now=eanser Public Work VE � Public Utilities Public Safety Date 0-wt41311e R,, i Fire Services BY: APPROVED CITY OF ATLANTIC BEACH _ Department of Public Works -- wr 1200 Sandpiper Lane Atlantic Beach, FL 32233 J,SI�r (904) 247-5834 PUBLIC WORKS REVISION PLAN REVIEW COMMENTS Date: 5/30/19 Applicant: Michael & Lisa Hosto Permit #: ACC19-0040 Email: michaelhosto@gmail.com Review Status: DENIED Site Address: 2329 Barefoot Trace THIS REVISION PLAN REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS Correction Items must be submitted to the Building Department at 800 Seminole Road. Submittals that respond to only one or a few correction items will not be accepted. Revisions may not be submitted until ALL departments have completed their respective reviews. Revisions must be submitted to the Building Department and must respond to EACH department review. PUBLIC WORKS CORRECTION ITEMS: • Driveway cannot go through sidewalk. Awkki lvt -i • Sidewalk must remain concrete. V CONDITIONS �/ ✓��✓� PUBLIC WORKS C O IONS OF APPROVAL: (The following comments will be printed on your permit as Conditions of Approval) • 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. • All runoff must remain on-site during construction. • 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. • Full right-of-way restoration, including sod, is required. • Maximum driveway width within the City right-of-way is 20'. Scott Williams, Public Works Director swilliams@coab.us/904-247-5834 Resubmittal Notes: All revisions and changes shall clearly stand out from the rest of the drawing on the sheet as a revision by way of completely encircling the change with "clouding". The revision shall also be identified as to the sequence of revision by indicating a triangle with the revision sequence number within it and located adjacent to the cloud. The revision date and revision sequence number shall also be indicated in a conspicuous location in the title block for each sheet on which a revision for that sequence occurs. For projects still in the initial review stage and permit pending, all sheets with revisions shall be inserted into each set of drawings. The original sheets must be clearly marked "VOID" but are to be left within the set of drawings. Complete new sets of drawings will not be accepted ADDITIONAL ITEMS MAY BE REQUIRED DEPENDING UPON NEW INFORMATION AND CLARITY OF FINAL PLANS SUBMITTED FOR REVIEW. Page 1 of 1 0:\Public Works\ADMIN\PLAN REVIEW COMMENTS\ACC19-0040(Owner-Hosto-Revision).docx ALL Revision Request/Correction to Comments **HIGHLI HIGHLIGHTED ON HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: v EI Revision to Issued Permit OR ❑ Corrections to Comments Date: Project Address: 2`302( Contractor/Contactt N-,ar'me:TUU/` r Contact Phone: [V'1 ' 7 ! 7 L/ Email: Dis;r ewd •See ROW loved 5-15-tq Description of Proposed Revision/Corrections: I ti/ affirm the revision/correction to comments is inclusive of the proposed changes. (printed name) • Will proposed revision/corrections add additional square footage to original submittal? ❑No ❑ Yes (additional s.f.to be added: ) • Will proposed revision/corrections add additional increase in building value to original submittal? ❑No ❑*Yes (additional increase in building value: $ ) (Contractor must sign if increase in valuation) *Signature of Contractor/Agent: (Office Use Only) ❑ Approved Denied El Not Applicable to Department Permit Fee Due$ Revision/Plan Review Comments Department Review Required: Building Planning&Zoning Reviewed By Tree Administrator ECEIVE 4E��t� REVISEQ7_��_ ues JUN 0 6 2018 Public Safety Date Fire Services BY: Updated 10/17/18 APPRO CITY OF ATLANTIC BEACH J Department of Public Works J r 1200 Sandpiper Lane Atlantic Beach, FL 32233 _Oil (904) 247-5834 PUBLIC WORKS 2nd REVISION PLAN REVIEW COMMENTS Date: 6/7/19 Applicant: Michael & Lisa Hosto Permit#: ACC19-0040 Email: michaelhosto@gmail.com Review Status: DENIED Site Address: 2329 Barefoot Trace THIS 2"d REVISION PLAN REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS Correction Items must be submitted to the Building Department at 800 Seminole Road. Submittals that respond to only one or a few correction items will not be accepted. Revisions may not be submitted until ALL departments have completed their respective reviews. Revisions must be submitted to the Building Department and must respond to EACH department review. PUBLIC WORKS CORRECTION ITEMS: APPROVED • Driveway cannot go through sidewalk. • Sidewalk must remain concrete. • Per telephone conversation - Must come to Public Works and sign off on documentation stating "Sidewalk pavers to be removed and concrete sidewalk added." The submitted signed Right-of-Way permit is not completely filled out and is not sufficient to address the above Correction Items. Please call 904-247-5834 to schedule appointment with Scott or Jennifer to sign the documentation. PUBLIC WORKS CONDITIONS OF APPROVAL: (The following comments will be printed on your permit as Conditions of Approval) • 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. • All runoff must remain on-site during construction. • 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. • Full right-of-way restoration, including sod, is required. • Maximum driveway width within the City right-of-way is 20'. Scott Williams, Public Works Director swilliams@coab.us/904-247-5834 Resubmittal Notes: All revisions and changes shall clearly stand out from the rest of the drawing on the sheet as a revision by way of completely encircling the change with"clouding". The revision shall also be identified as to the sequence of revision by indicating a triangle with the revision sequence number within it and located adjacent to the cloud. The revision date and revision sequence number shall also be indicated in a conspicuous location in the title block for each sheet on which a revision for that sequence occurs. For projects still in the initial review stage and permit pending,all sheets with revisions shall be inserted into each set of drawings. The original sheets must be clearly marked "VOID" but are to be left within the set of drawings Complete new sets of drawings will not be accepted. ADDITIONAL ITEMS MAYBE REQUIRED DEPENDING UPON NEW INFORMATION AND CLARITY OF FINAL PLANS SUBMITTED FOR REVIEW. Page 1 of 1 O:\Public Works\ADMIN\PLAN REVIEW COMMENTS\ACC19-0040(Owner-Hosto-2nd Revision).docx City of Atlantic Beach C 1 APPLICATION NUMBER JS Building Department 7> (To be assigned by the Building Department.) 800 Seminole Road ����� r' Atlantic Beach, Florida 32233-5445 if V't V r Phone(904)247-5826 Fax(904)247-5845 S ( � COM E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z3 7-9 &.1e. 12 Department review required Yes No Building__ Applicant: c. Planning &Zonin , Tree Administrator Project: P P Pr -Public Works u is Utilities �G �`0�,A, PuuFilic a e y �'` 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: APPLI "TION STATUS Reviewing Department First Review: Approved. ElDenied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: ��� Date: is/ 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 J Lv 4 Building Permit Application Updoted10/9/18 City of Atlantic Beach Building Department "ALL INFORMATION r 800 Seminole Road, Atlantic Beach, FL 32233 ��� HIGHLIGHTED IN GRAY `Oft � Phone: (904).247--5826 Email: Building-Dept@coab.us IS REQUIRED. Job Address: J� � �` FiClC--_i Permit Number: 0/ Legal Description Valuation of Work(Replacement Cost)$ l/7�D1� Heated/Cooled SF _Non-Heated/Cooled • Class of Work: ❑New ❑Addition ❑Alteration ❑Repair//❑Move ❑Demo ❑Pool ❑Window/Door 6t a— • • Use of existing/proposed structure(s): ❑Commercial Residential OFFICE COPY • If an existing structure,is a fire sprinkler system installed?: ❑Yes IfNo • Will trees he removed in association with proposed ro'ect? ❑Yes must submit separate Tree Removal Permit ❑No Describe in detail the type of work to be performed: JJ ✓�I UCG(/ '�� /�GC/���T Florida Product Approval# for multiple products use product approval form Property Owner Information_ / }plc Name 1 G /fUy` AGIf �fv Address 2,�r ,�Xd / vxG2- City Gt state Zip Phone /"L�/'`��I "z/l� W N E-Mail Cti r V Owner or Agent (If Agent, Power ofhtfiorn y or Agency Letter Required) (/1 N Contractor Information -J= Q 0 Uz _ Name of Company Qualifying Agent �' Q O LU Address City State Zip n ,,,, F- Z H Office Phone Job Site Contact Number U .. 00 U QO State Certification/Registration# E-Mail W Q Architect Name&Phone# 0 O Z Engineer's Name& Phone# N Workers Compensation Insurer OR Exempt❑ Expiration Date r•- Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or instal latioroa� W commenced priorto the issuance of a permit and that all work will be performed to meet the standards of all the laws regulati O W W }: construction in this jurisdiction.I understand that a separate permit must be secure for ELECTRICAL WORK, PLUMBING,SIGNU 0. Q Co WELLS, POOLS,FURNACES,BOILERS, HEATERS,TANKS,and AIR CONDITIONERS c. NOTICE: In addition to the requirements h� W H; 0 permit,there may be additional restrictions applicable to this property than ay be found in the public records of this county,Ind U N W W there may be additional permits required from other governmental en/� es such as water management districts,state agencies or X W Llifederal agencies. fw cc OWNER'S AFFIDAVIT: I certify that all the foregoing informati dli�s accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. ,f 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 RECO , [SINS;-YOUR NOTICE OF COMMENCEMENT. ignkur f Owner or Agent) (Signature of Zefore ctor) S' ed and sworn to(or affirmed)before me this ay of Signed and sworn to(or affirmed me this_day of by nature of Notary) ;', =='=� .fir. of Notary) TONI LESPERCcR MY C ; FISSION#FF 824551 1 / �� IRES:October 6,2019 Personally Known OR [ )Fer ;dlY` QWQ1R WtaryPub!'COnderNdter, ' [ ]Produced Identification Prbllre �dtii #�om� �� Type of Identification: QL Type of Identification: NOTICE OF COMMENCEMENT OFFICE COY State of L County of _.Tj�( �1 q Tax Folio No. I 9 4 G3 — 06- IL 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 this NOTICE OF COMMENCEMENT. Legal Description of property being improved: 141- 3`] I IL Address of property being improved: Si rr 7r �iC T 4f14-1 1-9yc &4 Z Z-73 3 General description of improvements: � 12 Owner: A--&I Address: 3,,2c2 ,� . J Owner's interest in site of the improvement: Fee Simple Titleholder(if oLerthan owner): Name: C Contractor: Ozlma&ce10 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: Wb-A—J(L 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 Signed: Date: Before me opersonally day of in the Coun of Duv 1,State Of Florida, ppe eQ �- D—onally Known: k A L or Doc#2019113744,OR EIK 18793 Page 1223, uced Identification: Number Pages:1 Public: Recorded 05/15/2019 02:17 PM, ,onunfission expires: --- RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00r TO 11 GINJJLESPERGER^ MY COMMISSION#FF 924951 ti EXPIRES:October 6,2019 Bonded Thru Notary Pubfc Underwriters Owner Builder Affidavit **ALL INFORMATION HIGHLIGHTED IN l City of Atlantic Beach Building Department GRAY IS REQUIRED. 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. IL INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. . III. 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 ALLTHE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. Job Address: 63a` � 7L :Zej-" 6--- A - _e- 3z Z T Owner Name: 1_f5 4 Phone Number: ���/IC-4 � Mailing Address: S City: S �'�-s ' State: /1 Zip: Notarized Signature of Owner Ther going inst ument was acknow1fedged before/me this Suay of 20 in the State of Florida, County of 1 r Signature of Notary Public -� [ ] Personally Known OR [ ] Produced Identification /' /0 Type of Identification: Z `-�� 3 Q -7 — Z .- 4 — Updated 10124118 TONT GINDLESPERGER MY COMMISSION k FF 924951 EXPIRES:October 6,2019 �'`` Bonded Thru Notary Public Underwriters RIGHT-OF-WAY/ EASEMENT PERMIT Permit#Issued by the City of Atlantic Beach PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES Job Address _Q9 l 3Phone Permittee �'j, - 1} cG -a,( j Email Iy rc y ,tom/1 ��cam_ 3 Gr'1lti / L'd Requesting Permission to Construct P 1-0 LLo _ ,az .dt- Location(Reference to Cross-Street) 6 4,aA lY k! b- P,7&2, k2 r�S� • 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 Director of Public Works,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 Director of Public Works 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 (BVI.t C,(.-C- 4j� (Project Superintendent) with Company Name_Aad /'2 Phone 8Z f-C-119 y • All materials and equipment shall be subject to inspection by the Director of Public Works. • 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 Director of Public Works 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 Director of Public Works shall be notified twenty-four(24)hours prior to starting work and again i telt' n completion. Date Pe mittee(si din esenc f Notary Public) S ATE FLORIDA,COUNTY OF DUVAL Q T e f going instrument was ackipwledged this day of I ,20 I 1, by 66657t� ,wh personally appeared before me and (printed name of Permittee) ac owledged t /s signed t instrument voluntarily for the purpose expressed in it. Personally Known re otary Public,State of ri a Produced Identification(Type) —;s >, • . Py, --. TONI GINDLESPERGER MY COMMISSION#FF 924951 - EXPIRES-October 6,2019 uF ° Bonded Thru Notary Public underwnters REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of tq,/-V -I 20h by the City of Atlantic Beach,Florida,a municipalorporation or ' ed and existing under the laws o the State of Florida,hereinafter referred to as"CITY"and L-CS US:l n 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 Right-of-Way Permit# This work is generally described as Any facility maintained, repaired, erected, and/or installed in the exercise qf the privilege granted remains subject to relocation or removal on thirty(30)days' notice by CITY to USER, said noti e to U ER shall be given by certified mail, return receipt requested,to the following address �_ � • 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 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 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 as ed by the SER. Date rj Prop Ox6n / en signed in presence of Notary Public) ST OF FLORIDA,COUNTY OF DUVAL t The foregoing instrument was acknowledged this day of 20 , by456 ,who personally appeared before me and ( nted name of Signer) ackn ledged tha she igned t e instrument voluntarily for the purpose expressed in it. Signature of Notary Public,State of Flor `•< Approved/Public Works Department: Personally Known Produced Identification(Type) Scott Williams, Interim Public Works Director ,A GINDL PERGER t.i r COMMISSION#FF 924951 EXPIRES:6ctober 6,2019 Bwded ki=,Y Public Undenveters MAP SHOWING BOUNDARY SURVEY .0 LOTS BLOCK "' AS SHOWN 0 MAP OF w,,z le. I-All r w� i AS RECORDED IN PLAT BOOK 4X PAOES/3-130 OF TR CURRENT PUBLIC RECORDS OF.DUVAL CO,,.FLA. FOR,_-COLL/CR e4o-vle A41,14er NOTE BEARING DATUM:SHOWN HEREON ARE BASED 0 THE'ABOVE MENTIONED AT. c r �/2E ADD 310= F «( Al a�. J TTTJ" Qv . I ,0•' ` �� a day N� �0 6•d 0A ka All, a hqj- rA (sem Evr� 1 •Of ?.G' ..:� � ?\ ��:: h� OALr W •Q.,,/L•� . .IS �. px PAl..rl ,a:gcy, PA,117 :r-x:' B •..SAY 26� EgSE.bJc.t/' ; 4�rF"i Qrt% ARAL✓T • 0 3�,��„ �. �. go.D' FINAL rv.�v�Y 7.:,�•A Jro.Act,A�Ioar . — . I + rOU�/D97A7 .1A/X✓RY QJ-B�,-,�(jY.£:•j(Y/AJp4I J.464�. lXld�•NO .0 7.��1"YAVA§H.Jt� 'T E • 1.'•OD . FL000 CEt�T1FICgLFs HEREBY CERTIFY 1 IAT TNG .LOT SHOWN NEREOH ISg AS BEST ASCERTAINED,W F1.000 �.., ulannAw" step_ coMMUNITY PANEL N• 120077-O_ /?FOR - 2326 Barefoot Trce - Google Maps Page 1 of 1 Goggle Maps 2326 Barefoot Trce y. K .. ,,. Image capture:Dec 2018 ®2019 Google Atlantic Beach,Florida Google Street View-Dec 2018 r 2 g U O https://www.google.com/maps/place/2329+Barefoot+Trce,+Atlantic+Beach,+FL+32233/... 5/16/2019 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 Job Address jt?n Permit Number Arc Contractor Information 1 _nn Company n �! C Qualifying Agent Address City State Zip Phone Email State Certification/Registration# Architect Phone Email Engineer 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) Phone • 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 expense arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. • The P is Work d 24 hours prior to starting work and again immediately upon completion. Date Permi a sig ed in p ence of Notary Public) ATE OF FLORIDA,COUNTY OF DUVAL The foregoing instrument wgs—b owledged this day of C 7 _ 20 by who personally appeared before me and (printed name of Permittee) facn dged t a signed a instrument voluntarily for the purpose expressed in it. =�:.�P;,g-. TONIGINDLESPERGER MY COMMISSION#F"i-924951 >�; = EXPIRES:October 6,2019 Bonded Thru Notary Public Underwriters ci, [ ersonally Knouv Signature of Notary Public,State of 10 r a [ ] Produced Identification(Type) H:\Applications&Forms\Word&Excel Document Originals\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18 tai.. 4!4,T 44 /^ ✓I ---/f I� 1 � t x , � t NNW y r rd5 , k n r , - • -,- .. a J � - � - '� '^��4 r • i �1... � f ter.'.:•.