90 S Forrestal Cir FNCE19-0088 4' & 6 FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH FNCE19-0088
800 SEMINOLE ROAD ISSUED: 8/26/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 2/22/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, ' OF • OF ORDINANCES .
ALL CONDITIONS OF • PLEASE
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:
90 S FORRESTAL CIR FENCE WALL OR BARRIER FENCE 4' & 6' FENCE $5000.00
TYPE OF
• :D •
• • GROUP:
1717510000 4TLANTIC BEACH VILLA #
01
COMPANY: ADDRESS: '
SUPERIOR FENCE AND RAIL 5470 HIGHWAY AVE JACKSONVILLE FL 32217
OF NFL
• err • '
TYSINGER MARK 90 FORRESTAL CIR S 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.
LIST OF CONDITIONS
'Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 7
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: 8/26/2019 1 of 2
is�ra,vr City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road F Iv C
Atlantic Beach, Florida 32233-5445
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: D S� rb F -e a ent review required Yes No
�Buildin
Applicant: �; - Planning&Zoning
Tree Administrator
Project: is Works—,
PUbIIC Utilities>
Public Sa ety
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. Cot
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: !�✓ ate: 7 Zl1/r
TREE ADMIN. Second Review: ❑Approved as revis d. ❑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
rs'A� %. City of Atlantic Beach APPLICATION NUMBER
5•� Building Department (To be assigned by the Building Department.)
r. 's 800 Seminole Road
Atlantic Beach, Florida 32233-5445 v
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: ro F,RFC I A1C, a ent review required Yes No
Buildin
Applicant: f)C
JPIanning&Zoni_ng__�
Tree Administrator
Project: -P-a ffl-c—W-®r FS—)
PublicUtilities�,
Public a ety
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: Qpproved. ❑Denied. []Not applicable
(Circle one.) Comments: )0 c'
UILDIN
B /V
PLANNING &ZONING 7"a 94
Reviewed by: m Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. v ❑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 05/1912017
City of Atlantic Beach APPLICATION NUMBER
>s Building Department (To be assigned by the Building Department.)
r� 800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
9' E-mail: building-dept@coab.us Date routed:
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: C l r-0jo:Qpp-artment review required Yes No
Klluildiaa..2
Applicant: - Plannin &Zonin
Tree Administrator
Project: Vu is Wor s
Public Utilities ,
Public a ety
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:
APP CATION STATUS
Reviewing Department First Review: Approved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by/)�2 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
rS��,vflJ, City of Atlantic Beach APPLICATION NUMBER
Building Department i (To be assigned by the Building Department.)
r 800 Seminole Road
Atlantic Beach, Florida 32233-5445 1 C7
Phone(904)247-5826 • Fax(904)247-5845 CC
E-mail: building-dept@coab.us Date routed: 27J
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 9D P-c ucsi n a ent review required Yes No
Buildin _
Applicant: — _ � Plannin &Zonin
Tree Administrator
Project: �- --Pu is Wor s
��Public Utilities
Public a ety
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 by: Date:
TREE ADMIN. UVIVY
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
REVOCABLE ENCROACHMENT AGREEMENT
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
existing under the laws of the State of Florida, hereinafter referred to as"CITY" and
of Atlantic Beach, Florida, hereinafter
referred to as "USE
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 Citv of Atlantic �O
� BeacIr/
This work is generally describea as r ala CU —f 1C`L
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject tc
relocation or removal on thirty(30)days' notice by CITY to MISER,said notice to USER shall. be given by certifi d mail.re urr
receipt requested,to the following address 3 w h (T` Se l9J LV 3410Z
• 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(hl
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 Citv 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
a5cianc
• 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 emplovees shall De
saved harmless by the USER from anv of the work herein under the terms of this permit and that all of said
liabilities are hereby assumed by the USEP.
-" Date
Prope Owner/ Ent signed in presence of Notary Public)
STATE OF FLORIDA. COL} TY OF DUVAL
The foregoing instrTment was acknowledged this 62c--) day of 1 20
by Deni _-_:sI 110(2 who personally appeared before me and
(printed name of Signer
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in i-
QA
OORGAN�y''% Department Approvai.
17--Ja
Signature of Notary Public. S to of Florida
cij ; NOTARY PUBLIC'••�N;
[personally known' - REG.0 _
= 7819787 - Scott Williams. Public orks Directc•
[ 1 Produced Identification(Typ^, - COMMIMON
EXPIRES :•'Q`
05/31/2023 2`
H:\ADolications&Forms\Word&Excel Document originals\201 �� Revocable Fncfer�eot Aereement.docx Revision Date:8/3:.
//�,//i ,ALTN OF\�s.�•
RIGHT-OF-WAY/EASEMENT PERMIT APPLICATION I "AL1 INFORMATION
City of Atlantic Beach HIGHLIGHTED IN GRAY IS
300 Seminole Road,Atlantic Beach,FL 32233 REQUIRED.
ERHi[TTEE
RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES �] p
Job Address _ rip a�,C 1.� _Permit Number E�6Eq0
(`�► �� D�
.,;ntractor Information
�'�/ `�
u--,
or �� uudnrying Agent �✓G.IV��
ddress�jpJ F V t' , Lai City (�urwi/llC State Zip
r V i i C /v J 6 ✓Y• i i i a i i k�`^'v�!/l r (�'�-y,U
()VState Certification/Registration#
cf itect Phone Email -
cngineer Phone Email
Norkers Compensation Insurer OR Exempt o Expiration Date
eermittee declares tnat pnor to Tiling this appiication they have ascertained the iocation of ail existing utilities,both aerial
u naerKround and the accurate locations are shown on the sketches.
• Whenever necessary for the construction,repair,improvement,maintenance,safe and efficient operation,alteration or
c�vcaiion or ail.or any portion or Sala street or easement as aetermineo by the Public Works Director,any or all said poles.
vires.pipes,cabies or other facilities and appurtenances authorized hereunder,shall be immediately removed from said
7eet or easement or reset or reiocateo nereon as required by the Public Works Director and at the expense of the
termittee 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 G/9G/Y (Project Superintendent;
with(Company Name) 13<-'Pc'cC'Idl� Iec c�'J `� r rv& & 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
~anner saiisfactory to the City.
+ N SKetcn 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.
• rite permittee snali commence actual construction in good faith within�_days_ If the beginning date is more than 60
:ays from date of permit approval then permittee must review the permit with the Public Works Director to make sure no
:nanees nave occurred in the area that would affect the permitted construction.
• tt is understood and agreed that the rights and privileges herein set out are granted only to ine extent OT 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
ana indemnity,defend and save harmless the City of Atlantic Beach from and against any and all loss,damage and cost of
2xgenses ans:ng ln any manner or the exercise or attempted exercises by the holder of the aforesaid rights and privileges.
• ine Public Works Direc�of shall be notified 24 hours prior to starting work and again immediately upon c mpletion.
Date
Permittee(signed in presen of Notary Public)
:-.ATE OF FLORIDA,COUN"F DUVAL � / , � � , C�
The foregoing instrument was acknowledged this�day of 20—1—�
IV S� l�1G� _. _ __--_ who persor��uy+A� ate¢7b,fore me and
printe—d n -of Permittee) `N. �M N� *e
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. kOrARy Pte`;'
REG.ar C' 7N
619787 -_
COMMISSION
Personally Knowr- SPIRES
Produced(dent on(Type °� S
mature of Notary Public,Sta of Florida l 1 ` .•
-of-Wey Easement permit Application.dod
r,:%AppliLations&Forms\Worcl&Excel noa.iment Originals\201801001 Right 'CC
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Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department *BALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
/� l
Job Address: 7 U Fa y e� ��r�L LS �l `N. it Number. l (y� �� +���
Legal DescriptionLtA 1 �j }C�[ 9,,6W0-0
2 i t IC�L GAG l V t wrn+ REO _
.aluation of Work(Replacement Cost)$ D!d0-0 Heated/Cooled SF Non-Heated/Cooled
rJass of Work: QNew ❑Addition ❑Alteration ❑Repair LMove 16emo ❑Pool OWindow/Door
use of existing/proposed structure(s): ❑Commercial &Residential
�-existing structure,is a fire sprinkler system installed?: ❑Yes ONo
• Will trees be removed in association with proposedproject? Dyes must submit separate Tree Removal Permit 9+4tc
[Describe in detail the type of work to be performed:
iorida Product Aoproval# for multiple products use product approval form
Pronertv Owner Inform�atiRa r
Name �Pit l 'r -� S(YI 4' Address IS VJI1 l Se
City State Zip 2 Phone
-ividii / -�l
Owner or Agent(if Agent,Power of orney or Agency Letter Required)
Contractor Information _ _
Name of Company DW'��' '�rl- '4 � �-�►G• Quali ing Agent `r r �/T ��
address �� t City State Zip
Office Phone - - 3 lob Site Contact Number - 2221 _
�+?te Certification/Registration# E-Mai lJ - (�l����J���'�•f�t?�1N5 J ----� V `�G (
Name&Phone#
::zineer s Name&Phone#
:Jorkers Comoensation Insurer f L�G�l��-� OR Exempt El Expiration Date d S 2LS
no!ication is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installation has
,.ommenceo onor 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 iurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
:ELLS. POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE:In addition to the requirements of this
zrmit,;here may be additional restrictions applicable to this property that may be found in the public records of this county,and
_dere may be additional permits required from other governmental entities such as water management districts,state agencies,or
:ederal agencies.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with ail
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
-0 OBTAIN FINANCINGCONSULTWITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING LOUR NOTICE Oji OMMFNCEMENT. -
(Signature Owner or/Agent) (Signa u f Contractor) NN
aa�P
Signed and sworn to(or affir ed)before me this 0aday of Signed and sworn to(or affirmed 00� y of
os Zc?F"
Y 50, Sr. r l r_T ,.u4,c, P y M m
Signature of No ry) _ o
e
/ ttt� XPersonallyKno nl,
i Prorsdona; o r 1`96i/ /[ ]Produced Identi-Qt �tl
• Type of Identificatio
-ape ai�4R..Won:
ARY PUBLIC'
REG.a tP
~ 781
' 9787
comul '
Map of Boundary Survey
LOT 1, BLOCK 2, ATLANTIC BEACH VILLA UNIT NO. 1,
A SUBDIVISION ACCORDING TO THE PLAT THEREOF RECORDED AT PLAT BOOK 30,
PAGE 56, IN THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
PROPERTY A DDRES S: 90 FORRESTAL CIRCLE S, ATLANTIC BEACH, FL 32233
10.0'UTILITY EASEMENT
Q / / LOT 15 y'
BLOCK 2 /
o /
011�
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Q' LB#8102 / / / BLOCK 2
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,
N69'31'25"W 75.00'(P)
/ POWER N69'34'18"W 75.06(M)
10,0'UTILITY / LOT 1 apo 9 POLE
EASEMENT BLOCK 1 RFSrl(O/O/NG \ CERT1FlEDTO:
A(4/NE / LOT 2\ BRANCH BANKING&TRUST
BLOCK 1 FIRST AMERICAN TITLE INS CO
/ DENISE TYSINGER AND MARK TYSINGER
6'WOOD FENCE 6'VINYL FENCE
LEGEND: SET IRON FOUND IRON CONCRETE 3'CHAIN LINK FENCE