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715 Amberjack Ln ACC19-0082 Shed 'Srl`J�1G' ACCESSORY PERMIT PERMIT NUMBER r s, ACC19-0082 CITY OF ATLANTIC BEACH ISSUED: 10/30/2019 800 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 EXPIRES: 4/27/2020 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, 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: ACCESSORY SINGLE OR TWO construct 10-ft. x 15-ft. shed 715 AMBERJACK LN $2400.00 FAMILY ACCESSORY in backyard TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 171194 0000 ROYAL PALMS UNIT 01 COMPANY: ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ZIP: TAYLOR MEREDITH 715 AMBERJACK LN 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. 1 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. 2 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod, is required. Issued Date: 10/30/2019 1 of 2 rsyV`'49 ACCESSORY PERMIT PERMIT NUMBER s, CITY OF ATLANTIC BEACH ACC19-0082 Jv v 800 SEMINOLE ROAD ISSUED: 10/30/2019 J'; tY ATLANTIC BEACH. FL 32233 EXPIRES: 4/27/2020 3 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 4 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL Notes: Water runoff from shed must not go to neighbors lot. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $65.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $32.50 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 ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00 TOTAL:$226.50 Issued Date: 10/30/2019 2 of 2 i,:Ly City of Atlantic Beach APPLICATION NUMBER `r ii op JS ) Building Department (To be assigned by the Building Department.) r .' 800 Seminole Road 4 CI A ( � _a(�� Atlantic Beach, Florida 32233-5445 J l�6 Phone(904)247-5826 • Fax(904)247-5845 i a f -a- (( P�,o;t]9 E-mail: building-dept@coab.us Date routed: f 6l ci City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1 ..S- f e- C((.,�- , t-41 , Department review required Y7 No Applicant: 0") ni--v( Plani &Zonin) Tree Administrator Project: ui(LS`vi.tuk icy _by - P P . A A . S rte& `4 bkC tG,rcf Public Sti afe 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. krDenied. ❑Not applicable (Circl- ..-. Comments: BUI r PLANNING &ZONING Reviewed by: rn�/ Date:/b'.)2 .)O/? TREE ADMIN. (J Second Review: Prpproved as revised. ['Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: /0—d-3-I9 FIRE SERVICES Third Review: ['Approved as revised. Denie ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 OFFICE COPY e Revision Request/Correction to Comments **ALL INFORMATION d�5 !`!� , HIGHLIGHTED IN =- -14k City of Atlantic Beach Building Department GRAY IS REQUIRED. "WO": 800 Seminole Rd, Atlantic Beach, FL 32233 u::'!P Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: Re 0 i9 -008� Revision to Issued Permit OR ❑ Corrections to Comments ` I Date: Project Address: -1 1 `.. 2-3�k— L� -k- l!�'L-k"itc, i. 'Pt ';zZ-.3.) Contractor/Contact Name: V-4.—s..A._.- j Ad ALIY----- Contact 15hbne: Cioli- k't%` -)11(\&-kY4--.11.--,1 , _� yekt,,„ • C � Description of Proposed Revision/Corrections: ' .,-)-- a.< C v--k- c-A—L.1.*- . RECEIVED ibi tr-, ,,,c, ..,_ , , i .-- `v/ .1(4 ..e L a .• I 2 2019 i ---C9 0 C- -Lto (e).e___ ezt,-kA.t\,,i+,. I V-0____.,L�4t 4 k9-t------ affirm the revision/correction to comments is inclusi tlailigdaes2a ,►3 t (printed n e) City of A"^ht!C e'z:1Gh, FL • proposed revision/corrections add additional square footage to original submittal? ❑ Yes (additional s.f.to be added: ) • 'll proposed revision/corrections add additi nal ncrease in building value orginal submittal? ,11,10...._ ❑*yes (additional increase in build g alue: $ ) (Contractor must sign if increase in valuation) *Signature of Contractor/Agent: (7.74 - L (Office Use Only) Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$ Revision/Plan Review Comments Depaxtm.nt Review Required: Building )14‘ ). P anriing&Zoning Reviewed By Tree Administrator Public Works 0 cc�� Public Utilities / /1 �r c9 0/ .7 Public Safety Date Fire Services Updated 10/17/18 _, r. , ii•' Js� " ` '}SS1 CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD OFFICE C0PY ATLANTIC BEACH, FL 32233 (904) 247-5800 BUILDING REVIEW COMMENTS Date: 10/22/2019 Permit#: ACC19-0082 Site Address: 715 AMBERJACK LN Review Status: Denied RE#: 171194 0000 Applicant: Property Owner: TAYLOR MEREDITH Email: Email: kbtaylor16@yahoo.com Phone: Phone: 9048038001 THIS REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS. Revisions may not be submitted until ALL departments have completed their respective reviews. Revisions submitted MUST respond to EACH department review. Submittals that respond to only one or a few correction items will not be accepted. Correction Comments: 1. Met with owner builder who will resubmit details on framing and continuous tie-down information and other details concerned with the wall section and footer/grade issues.. Building Mike Jones Building Inspector/Plans Examiner City of Atlantic Beach 800 Seminole Road Atlantic Beach, FL 32233 (904) 247-5844 Email:mjones@coab.us 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. SyL�ri,: City of Atlantic Beach APPLICATION NUMBER pS rit .‘ Building Department (To be assigned by the Building Department.) y 800 Seminole Road A AA l _O c ia • Atlantic Beach, Florida 32233-54451 ti Phone(904)247-5826 Fax(904)247-5845 Date routed: to vi r 1E-mail: building-dept@coab.us City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1 4S tkin JGt(, • Department review required Yes No Buil.1 s Applicant: O (\L-( Tree dministrator Project: dLS�1.LC�� la Pt .)) 1 _ P c � o ,`'aQL Public Utili S ' ti\ bk_c_1r'kfa 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. I INot applicable (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by: L � Date: 1 1 • �'ZZ' `j TREE ADMIN. Second Review: n ❑Not applicable - Approved as revised. Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: I lApproved as revised. ['Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 (/ iJiJl City of Atlantic Beach EC 4~ APPLICATION NUMBER S .� Building Department (To be assigned by the Building Department.) 800 Seminole Road OCT 2 2 2019Ate-14-00a- -- 0 Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 r r "��;;.1. 1 E-mail: building-dept@coab.us Date routed: 10 F e-a— b t 6.7 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ' 4J tkeltfAi c LL41 , Department review required Yes No Buil Applicant: n i &Zoning) Tree A dministrator Project: UdLSVl.(_CA la P _)9115---r--*. P oalt►1 t ,Q Public Utili '` S -A - ilk bk-C � L( 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: APPL CATION STATUS Reviewing Department First Review: Approved. Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING ..-7Reviewed b : ,� 4 I ate: TREE ADMIN. Second Review: Approved as revised. ❑Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: I 'Approved as revised. Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 ,:0,A�%; City of Atlantic Beach APPLICATION NUMBER fJs rf, Building Department (To be assigned by the Building Department.) r 800 Seminole Road Q �1 A ( � a(`�� , Atlantic Beach, Florida 32233-5445 A l�6 KPhone(904)247-5826 • Fax(904)247-5845 r r \J;iltr E-mail: building-dept@coab.us Date routed: tO f ��6I.CI City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: J d"\ -I C ,LL1 . Department review required Yes No Buil Applicant: O" AJ-✓ Plan i &Zonin� (� � �� Tree A dministrator Project: f1.S`Vl.(_Cit la P _ •i• S 1 Y�k ax bo_cl6N � 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: APPLI ION STATUS Reviewing Department First Review: I Approved. ['Denied. Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by. GL---•7/..-- ate:/O - 22 TREE ADMIN. Second Review: ❑Approved as revised. Denied. IiNot applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: I (Approved as revised. [Denied. [ INot applicable Comments: Reviewed by: Date:_ Revised 05/19/2017 ,''s'- '''%,,, Building Permit Application Updated 10/9/18 City of Atlantic Beach Building Department **ALL INFORMATION 73111r- ( 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY -u'ii�rIS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us ,*� �i / Job Address: 7 t' A M8- 2.3& & LA1�I Permit Number: A-Lit t/v t q - -,-- Legal Description 30-COO - yr/_ pAt/as r1iU� / Li)-7-1 8/k S RE# 1-7 lig y—OOc7Q Valuation of Work(Replacement Cost)$ 2.'10O Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition ❑Alteration ❑Repair [Wove ❑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 tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) ❑No Describe in detail the type of work to be performed: i‹+ 4 i L WA tc -\E ) .1 ,-'..-le---- YAP---_b (ate sig) Florida Product Approval# for multiple products use product approval form Property Owner Information Name << i's•It- EV-kp. I-O? Address ?I�'AN�,11lC2-I-AC Y-- LAIN-1 ECity A`TLAg A-1 - State L Zip 5 2--7_ Phone q 0 9 - v o 5 --v UO J E-Mail Kii-r tog-4. @ yA--/oO . c_2).,� Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company Qualifying Agent Address CityREC-EwED- Office Phone Job Site Contact Number State Certification/Registration# E-Mail Architect Name& Phone# Engineer's Name&Phone# OCT 2 1 2019 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 staBlialrilleling Department construction in this jurisdiction. I understand that a separate permit must be secured for ELE q 4 E1 ;, 1. WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS, etc. NOTICE:In acditionlto 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 N YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO e'B AIN FINANCING, • 1 LT WITH YOUR LENDER OR AN ATTORNEY BEFORE REC if 'DING .5* , • i OF COMMENCEMENT. (Signatu e of Owrr or Agent) (Signature of Contractor) • Sig ed and sworn to(or affirm:- before me th'r day of Signed and sworn to(or affirmed)before me this day of , , b A. i f '.L. i ,by .or .41t. P111:4.i 1 _A— (Signatu,e of Notary) (Signature of Notary) �''`"' CHERYL A GARCIA y '� �; [ ]Personally Known OR ersonall Knot7ui I;: : MY COMMISSION#FF977394 [ ]Produced!der ,e-:iii" [ ]Produced Identification e,,1 • EXPIRES March 31.2020 Type of Identificat' Type of Identification: � 1 anotery5•v &com Doc # 2011155800, OR BK 15659 Page 129, Number Pages: 2, Recorded 07/18/2011 at 01:22 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $18.50 DEED ~ DOC ST $868.00 t t Prepared By and Return To: OFFICE COPY Nikki Bourre I Landmark Title 4540 Southside Boulevard,Suite 702 Jacksonville,Florida 32216 IFile No.:LMT 11-430 4 Grantee's TIN: tJ I T I M General Warranty Deed , � Made this July 8,2011, By Annarene F.Welch,a single woman,whose address is:7910 James Island Trail, 1 N Jacksonville,FL 32256,hereinafter called the Grantor,to Meredith Taylor and Kenneth Taylor,wife and husband Iwhose post office address is: 139 Saltwind Circle,Neptune Beach,Fl.32266,hereinafter called the Grantee: ..C) (Whenever used herein the term"Grantor"and"Grantee"include all the parties to this instrument and the heirs,legal representatives and assigns of individuals, and the successors and assigns of corporations) Witnesseth,that the Grantor,for and in consideration of the sum of Ten Dollars,(510.00)and other valuable 1 consideration,receipt whereof is hereby acknowledged,hereby grants,bargains,sells,aliens,remises,releases,conveys and Iconfirms unto the Grantee,all that certain land situate in Duval County,Florida,more particularly described as follows: Lot Nine(9),Block Five(5)of ROYAL PALMS UNIT ONE,according to the Plat thereof as recorded in Plat Book 30,Page(s)60 and 60A,of the Public Records of Duval County,Florida. 3 Said property is not the homestead of the Grantor(s)under the laws and constitution of the State of Florida in that neither Grantor(s)or any members of the household of Grantor(s)reside thereon. J Parcel ID Number: 171194-0000 1 Subject to taxes accruing subsequent to December 31,2010. i Subject to covenants,restrictions and easements of record, if any;however,this reference thereto shall not operate to reimpose same. Together with all the tenements,hereditaments and appurtenances thereto belonging or in anywise appertaining. 3 To Have and to Hold, the same in fee simple forever. 1 And the Grantor hereby covenants with said Grantee that the Grantor is lawfully seized of said land in fee simple; 1 that the Grantor has good right and lawful authority to sell and convey said land;that the Grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever;and that said land is free of all encumbrances. 1 1 1 1 I I OR BK 15659 PAGE 130 In Witness Whereof, the Grantor has signed and sealed these presents the day and year first above written. Signed,sealed and delivered in our presence: K , ha.A - Pte. U/15/IALUI (Seal) ~— Annarene F. Welch, by Michele W. Lueders, her power of Wanes,Primed Name 311111,1%.*r4j attorney in fact 11. � e�fL%`` - (Seal) Witness Printed Name-.6 9 R.7 M • l State of Florida County of Duval The foregoing instrument was acknowledged before me this 8th day of July,2011,by Michele W.Lueders,as attorney in fact for Annarene F.Welch who is/are personally known to me or who has produced FfaL as identification. JOHNNI NICOLE G.',URRE ff� No ry Public MY Cin:, 3SIONxiii~.,W2rtI EXPII:ES s..•...i s 7yt 1 t i OFFICE COPY t�L Owner Builder Affidavit **ALL INFORMATION HIGHLIGHTED IN "ffri y City of Atlantic Beach Building Department GRAY IS REQUIRED. �°" 800 Seminole Rd, Atlantic Beach, FL 32233 JjS�r 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. . 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 ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. Job Address:'/ 1 tc- �✓� �I.,��A�� i-� ALP 1 iC=12,6404 Owner Name: T t I' ✓ Phone Number: CIO`{ " ��3-�5�a f Mailing Address: —7 y: 4t41(1. :J -State: j. Zip: ! 2 2 3 Notarized Signature of Owner e77 The foregoingy{�s rument was acknowledged before me 14 say of be-j 20 I��in the State of Florida, County of �Jt,i,U l.(� Signature of Notary Public(at (0 . yl_.34aket �✓ '�' CHERYL A GARCIA Personally Known OR [ ] Produced Identification ;;?.• ' �;-: MY COMMISSION#FF977394 •', �; EXPIRES March 31.2020 Type of Identification: (407)398-0153 FlondatiotarySenetca,tom Updated 10/24/18 01-Allic, TREE & VEGETATION AFFIDAVIT FOR INTERNAL OFFICE USE ONLY :' -\�f City of Atlantic Beach PERMIT# r A I -3 Community Development Department 75 7firfr-:!: 800 Seminole Road Atlantic Beach, FL 32233 WI >' (P) 904-247-5800 SITE INFORMATION ADDRESS 7 1 A mz5-pc(4-- i, P M Ajcuc 3.&-Ac iL P( 3 2--z- ) SUBDIVISION ?oL/kL 1 14-1--M, BLOCK LOT RE# / 7/ / ( q dcDcO RESIDENTIAL ❑ COMMERCIAL ❑ OTHER APPLICANT INFORMATION /� NAME u6;,3(6 I tT Lg_ PHONE# 9p4_gO,-goof ADDRESS —1(S--- A&Ai f — L A-,,, CELL# CITY14r .&AG4.1 STATE AI_ ZIP CODE '- -ZZ '3 EMAIL V__CK-4,12—tio Q 1 /14.6.m gOWNER ❑ LEGAL AUTHORIZED AGENT I affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation", of the Municipal Code of Ordinances for the City of Atlantic Beach Florida and/or I have participated in a pre- application meeting with the Administrator of those regulations. Subsequently, I affirm that no regulated trees and no regulated vegetation will be damaged, destroyed and/or removed from the above-described property and/or adjacent properties including right-of-way. I H •EBY CERTIFY THAT ALq RMATION PROVIDED IS CORRECT:Signature of Property Owner(s)or Authorized Agent .V. ,. �c,-NEk 1_ ( r° _ z ' —1"l GNATURE OF APPLICANT PRINT OR TYPE NAME DATE • SIGNATURE OF APPLICANT(2) PRINT OR TYPE NAME DATE Signed and sworn before me on this 0- ( day of L}GTo 36_2 , `"/1 by State of Y=riz),-ID 2 IZ6,-....1.--rl-f- `j A1`o,.L ' County of �vt4✓:"(-- • Identification verified: F-1-e- t A- 1----'.› I' Oath Sworn: g,es I fly— — — — — — -- — — 's,Y Pii- ALBERT MORENO 1 � `�� r Notary Public-State of Florida Not:ry Signature �F Commission#GG 304875 vi\--0,- -.-,4-(f- (26 of c.°` My Comm.Expires Jun 9,2023 Bonded through National Notary Assn. i Commission expires v ®7 g 3 a 04 TREE AND VEGETATION AFFIDAVIT 03.01.2018 PUBLICjWORKS PLAN REVIEW COMMENTS l G Date: /d - �v J Application#: C� nQ d Z Project Address: ,745-- i -f1/ G��_k J J . CONDITIONS OF APPROVAL TO PRINT ON PERMIT Check Box to Select All concrete driveway aprons must be 5" thick,4000 psi, with fibermesh from edge of pavement Driveway to the property line. Reinforcing rods or mesh are not allowed in the right-of-way. 0 Apron (Commercial driveways—6"thick). Full erosion control measures must be installed and approved prior to beginning any earth Erosion disturbing activities. Contact the Inspection Line (247-5814)to request an Erosion and Sediment 0 Control Control Inspection prior to start of construction. Onsite All runoff must remain on-site during construction. 4]'/ Runoff Post Const. If on-site storage is required, a post construction topographic survey documenting proper TOPO construction will be required. All water runoff must go to retention area and retention overflow 0 Survey must run to street. Pool Pool—Wellpoint(if used) must discharge into vegetated area 10' minimum from street or drainage ❑ Wellpoint feature (swale, structure or lagoon). Roll off container company must be on City approved list (Advanced Disposal, Realco Recycling, Roll off Shapells, Inc., Republic Services, Donovan Dumpsters, Phillips Containers,JDog/Dennis Junk ❑ Container Removal,All American Roll Off,WCA Waste Corporation). Container cannot be placed on City ROW. ROW Restoration Full right-of-way restoration, including sod, is required. Utility Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid ❑ Road Cut 10' in each direction from the center of the cut. Repair must be shown on the plans. Construction Provide construction site management plan, including location of silt fence, dumpster, portable ❑ Site Mgmt. toilet. Right-of-Way Permit is required if using right-of-way for construction parking. Runoff All runoff must remain on-site. Cannot raise lot elevation. Document Strongly suggest thorough documentation of impervious areas be recorded. 0 Impervious Slab Slab and driveway to be fully removed. 0 Driveway Maximum Driveway Maximum driveway width within the City right-of-way is 20'. 0 Circular Maximum circular driveway width within the City right-of-way is 12'. 0 Driveway Grass Full site to be grassed. 0 TOPO Must provide a topographic(TOPO)survey with water retention for final CO Inspection. 0 Survey Revision Any plan change must be submitted as a Revision to the Building Department. 0 Fencing All old fencing and debris must be removed from job site by Contractor. 0 Removed Decking All old decking and debris must be removed from job site by Contractor. 0 Removed Infra- Any damage done to infrastructure must be repaired by Contractor. 0 structure e raft op, 1,4e114 -id 'twi n(11-p) kc?lia ti Revised 2/26/19 pivalotio, or, Vftiad .414r/ QLD � .— --7)l ��0� 12/2 LTi/ A ,Y1-)i-z"--z7_ ylvi161/ �/ ay_X ,. .. " OR N '�" ltilMtNpnemarmow '�. s .. 4. lir • • 1 ,ir At la t ti 11. • • iY _ '" ' Sia .. atm f :7 „Iii' 4,.bra ' 8"SEWERMAIN 1 1 UI. ft' r',1*, , i 7o5• •tr # i f tyKv r MHA • 4 r . . poi Aimil L ^"^•arm , Ammillk n - 181 CJ A. R a 'Y,a_ I 4 y .di. It '1,'"4- \ it% ' �': 1112 a ,.:4.• k 7 w, a. Y r 0. p j;kap ;� ° �'� ..c a y '�+. •r ._ *�. kik Ordered By: 1 f 1 1 — I Y LAL? +.D?�ARK 8 WM4E�1. liir .. , V. T; I T L E stn- t ' i m 1 904 - 998 - 9733 N's .11drr 0 co. • PROPERTY ADDRESS:715AMBFRJACKL1NATLANTICBEACH,Florida32233 SURVEY NUMBER:FL1106.2002 FIELD WORK DATE:7/1/2011 REVISION DATE(S):(r.,..o 71112011) — LOT 2 I FL 1108.2002 BLK 5 MP 1/2' LHI.r.5 O BOUNDARY SURVEY NO ID L-3 3 a LCLrOT.5 COUNTY 4' 11A1 N y--W-. Fir'I/2' DUVAL /�1K ✓�i SYU.E.{D.E. _ ND ID .ii...,1 El; •.S'OFF L-1 has-� N 85°20'02'W 80.65'0150.27TM) /� LOT 9 (B.R.Per Plat) a �0 L-2 LS' } . BLK 5 i `%� N 04°39'58'E 93.00'(F) : I • too. •.1 1.515 I Z� N 04°44'01'E 92.65'(M) 100 0 L-3 OPFI.t..., 4 S 85°2002"E 30.651P) 0 • S 85°29'29'E 80.68'(M) LaLTK sD j ° N 34.3' L-4 W' .1 �ro LOT a l� . N 85°2002•W 29.54'(PM) out EL/5 2.(,,,,4,'co To -.- I STORY RES a N r°rr) I L•/ ,1,' 22 - #715 O O I �k+ f{� �`r,:� 412.3' 13.7' N N • ------ --•-22.5,111._ 5 �I I.Sorr I I FIRC 51.5 N L130548b PIP 1/2' P.C.or LOT 8. • L-1 (6.R.) NO ID L-4 my,.5 I• 0 --fit0Offireee4Ci s PRro $4 MBE 81 b CK LN. 60 R/W/" Wt t gin! __, I BK 2 ' • LOT 2 PIP 1/2' • BLK 2 NO ID®N. �� r. 57pp LOT I P.C.OF LOT i",C, SE n1144ZO NOTES BLK 2 I.BLK z I hereby cue,. at th,¢IIetch o' rvey of the hereon -FENCE OWNERSHIP NOT DETERMINED. described pr.• has b a. 'Cr y d,r�ctlon, -LOT APPEARS TO 6E SERVICED BY CITY WATER AND SEWER. I and to the• - • '-• o+I•A.y 4y •elief,It 15 a true -SETBACK LINES SHOWN ON PLAT,NOT VERIFIED. and accurate .{. -0. ., . r su that meets the mlrnmum tech star,etrrd3aset f by the Florida 70 0 15 30 / Board Of Prof-_ ..nal Uoneturv�. as described 1n !// Chapter 5J-17•'' ; Imstrative Code. su12V GRAPHIC SCALE (In Feet) = 30' ft. IN, p Ronda Pr A.STEPt1EN50N 1 inch �� / State of Honda Profaswnal Surveyor and Mappu \\\\ 1100050 No.6521 �� Use of This Survey for Purposes other than Intended.Without Written Verification,will be at the UserS Solo Risk and Without Liabllrty to the Surveyor. Nothing hereon shall be Construed to Give ANY Rights or Benefits so Anyone Other thnnthose Cenlfied. POINTS OF INTEREST l.W00D SHED IN U.E.&D.E. 2.FENCE IN U.E.&D.E. FLOOD INFORMATION: • By performing a search at www.fema.gov,the property appears to be located in zone X&C.This Property was found in CITY OF ATLANTIC BEACH.community number 120075,dated 04/17/89. CLIENT NUMBER: DATE:7/1/2011 LARA HOFFMAN,REALTOR® BUYER:MEREDITH TAYLOR 1NWW.LARAHOFFMAN.REMAX.COM Lry/�yj l >" LARAREALTOR@YAHOO.COW; 4C�'�' SELLER:JUNIOR S.AND ANNARENE F.WELCH (904)465-3140 Unlimited CERTIFIED TO:MEREDITH TAYLOR;LANDMARK TITLE;FIRST AMERICAN TITLE INSURANCE COMPANY wwwsurveystars.com - - Land Surveyors, Inc. P 866-735-19t6•F1366-744-2852 This is page 1 of 2 and is not valid without all pages. 1LBa 7337 12220 Towne Lake Drive.Suite 5s•Ft.Myers,FL 81913 REPORT OF SURVEY FL1106.2002 This is page 2 of 2 and is not valid without all pages. LEGAL DESCRIPTION: Lot 9,Block 5,ROYAL PALMS UNIT 1,according to the plat thereof,as recorded in Plat Book 30,Page 60,of the Public Records of DUVAL County, Florida, • JOB SPECIFIC SURVEYOR NOTES: The Bearing Reference of N 85 degrees 20 minutes 02 seconds W,is based on the northerly right of way line of AMBERJACK LANE,located within the ROYAL PALMS UNIT ONE,according to the plat thereof,as recorded in Plat Book 30,Page 60,of the public records of Duval County,FL GENERAL SURVEYOR NOTES: 1. The Legal Description used to perform this survey was supplied by others. This survey does not determine or imply ownership. 2. This survey only shows improvements found above ground.Underground footings,utilities and encroachments are not located on this survey map. 3. If there is a septic tank,or drain field shown on this survey,the location is approximate,and was determined by visual above ground inspection only,and cannot be relied on for acalracy. 4. This survey is exclusively for the use of the parties to whom it is certified. 5. Additions or deletions to this survey map and report by other than the signing party or parties is prohibited without written consent of the signing party or parries. 6. Dimensions are in feet and decimals thereof. 7. Due to varying construction standards,house dimensions are approximate. 8. Any FEMA flood zone data contained on this survey is for informational purposes only.Research to obtain such data was performed at www fema.non. 9. All comers marked as set are at a minimum a/diameter,18"iron rebar with a cap stamped L8H7337. 10. If you are reading this survey in an electronic format,the information contained on this document in only valid if this document is electronically signed as specified in Chapter 5J-17.062(31 of the Florida Administrative Code.The Electronic Signature File related to this document is prominently displayed on the invoice for this survey which is sent under separate cover.Manually signed and sealed logs of all survey signature files are kept in the office of the performing surveyor.If this document is in paper format,it is not valid without the signature and original raised seal of a Florida Licensed Surveyor. 11. Unless otherwise noted,an examination of the abstract of title was NOT performed by the signing surveyor to determine which instruments,if any,are affecting this property. 12. The symbols reflected in the legend and on this survey may have been enlarged or reduced for darity.The symbols have been plotted at the center of the field location,and may not represent the actual shape or size of the feature. LEGEND: prxnNOARvuNE 5URVEYOR5 LEGEND MC wR CONDIiiON:AO 10. D AT PUIION D.R DUW NO RDO[DXp tie int.ROD 502 SCREEN STRUCTURE ME IP IRON PIPE STY. STORY A' I ea u,cu,ATt➢ U NS LUCCI•_DL.IN'm$ sw SCTDACICUNC UN MQ Ce CAE TV.Risen l5/ LICENSE a-SURVos s c SIDEWALK . CONRETEDLOOLWALL CA. CENTER UNE LP. UGHT POST S.C.L. SURVEY CLOSURE UPS CMNIN-EMR Y wee1910E - 'CONE CONCRETE IND MEASURm S.T.I. SURv[Y T[use •.C.V.G. CONCRETE VALLEv cur rot N.A O. TEL TEIEnrONE rAOlrrls woos max:- 0CANCRETE sue N.R. NON RADIAL T.OD. TQ'Of DANA MDR FENCE • CSM' CONCRETE S SEWAIIC N.1.5. SOT TO SCALE TRANSroRM[R CA.rQ1 - or cowers,POso, L- OVOrnEAD use eYP. TYPICALTYPICALCOR CORNER OH. OVERHANG wRfn re CORNER Cour Co WATER �- CD/ DEED L PARALRL ,w . LLON t, Y? mATnere L D.N. O0 HOLE roe, rnor00ONAL SURVEYOR AND MAPPER wM wATBLMnOI K%-:-,4 U..;� DAV DR1VLWuy PL PROFESSIONAL LAND SURVEYOR PM1A-Li DRHl or Tilt RAT ND ELECTRIC UnUTYDON NE root EOUIPMrxr A.11 n-InOR cu.w,.:EAr tL--1t Ga- ENCLOSURE 1.o.8. POINT Or MORNING C:I.C. LA\I;MA\Te'.a'..a E.O.r. EDGE or rAVEMOn P.D.C. PONT OPmMMDuGetreNr WADER COVERED E.O.W corer Of WATER P.T. POINT Of TAYGR¢Y C.ct. Lrr:rY'_T._',SSW. roc. rCNCE our P.C. POINT OF CURVATURE v E. one cast EAhEMEA r TIP PENCE RAT P.C.C. POINT or comeoUND c1:RVAT1am ESlit. USO:t,T ® ea.,MARA on rote ',LC. PONT Of REVERSEMtVATURE I P..51 RIGRESS,Ereten ESN, • ••., cxcoa TE°POINT I'.1.. riursaED FLOOR PCP. f maa.ne,a cowrno,PONT a a.E. a M'TE.'ACCESS 1.n. CENTRAL or DELTA PPL_ . f1OWOA POWER$LIGHT PRIN. PERMANENT REfleWQ MONUMOIT ISE IANM:SLAai e':"res enYt COATROL POINT PANT „pp,pg....DR „,:g., W R. RADIUS or RADIAL LME 'cY:a,55C.r'C ■ CONCRETE MONUMENT me POUND IRON ROD•UP RAD. RADIK TIE MxNT.:A•;G!LawmAn'.1 ® UTOI 9A iN RFC FOUND IRON PIPE•UP RES. RESIDENCE •.E. MA..rE\r.er cxstvr:r ClNAl10N PRL FOUND IRON ROD RAV e SGHT Of WAY 1 U E e o\'L UT-TY EASIWEI IT (IRE HYDRANT fir POUND IRON PIPE SN•SLOG 9n Neil♦D15C 1.5•7337 R.O E. ROC'WEtsvr.E}`:i. O MµnO;C PCM POUND CONCRETE NONUM[M SIRE SET IRON ROD 1 CA?LDl]93] `+-LV E. SfOC'MN(L`V T. e: TREE re. POUND NArcA DISC son SET ORAL HOLE r U E. .:-1\d D:.L;A-Ur.IT•.' C InI�-�S rwT FOUND N..ns TAB SOY SEPHC TANA r-AC:YLAr otu GNO.T FOUND NA SEW. SEWER 1::. LI,Tv EASEME'.i GAIL GARAGE 5.W. SEAWALL ELECTRONIC SIGNATURE: PRINTING INSTRUCTIONS: OFFER VALID ONLY FOR: In order to"Elecronially Sign-all of the PDFs sent 1.While dewing the survey in Adobe Reader,select the MEREDITH TAYLOR by STARS,you must use a hash calculator A free "Print-button under the"File"tab. online hash calculator is available at 2 Select a printer with legal sized paper, f -1 61101were.fileformatinfo.RooL_md5sumhtin7 . =. �y To Electronically SignarryslTrvey PDF. 3.Under"Prim Ranga,didc select the"AJl"toggle. r -" Y• s.a'°ti _.. •_-' 4.Under the"Page Handling"section,select the number 1.Save the PDF onto your computer. t -- - '"`• 2.Use the online tool at of copies that you would like to print_ POOL•FENCE•ADDITIONI tiMp:!/Wtvyjfilefnr[n_pTJnforeolfmd.5S.um,km 5.Under the-Page Scaling"selection drop down menu, i - _ to browse for the saved PDF on your computer- select"None.' I 3.Select the Hash Method as SHA 6. Uodredc the"Auto Rotate and Center'dredrbox. 4.Clidt Submit 25% O I 7,Chedc the"Choose Pa b PDF'the bbox Your PDF is electron lolly signed d all of the per site y I (UP TO550 I ro characters in the SHA-1 code submitted by STARS 8.Click OKmo print I ANY FUTURE matches the codewhich is produced Iv the hash TO PRINT BIAIX+VNiffE, I SURVEYING SERVICES I calculator.Ifthey match exactly,your PDF is 1.In the main print screen,choose"Properces'. I ON THIS PROPERTY I electronically signed If the codes do not match 2.Choose'Quality from the options. t]tteiv�d o�J roc the exactly,your PDF is not authentic I. YCWros Csiea-Dn the 3.Change from•Auto Color"or-Full Color to lint pogo or'ho survey--slot dicast ncl Io "Gray Scale'. f I eyceeC$SCO _ t -a f'`; '` Exacta Land Surveyors,Inc. wwwsurveystars.com L8117337 P 866'735-1916•F 866-744-2882 12230 Towne Lake Drive,Suite 55-Ft Myers,FL 33913 • • • • • • a t I l kill SLRlo IDN • 0 It 41 • t - •r � • t 0 d • ANIClh .46 i,oL prc • z • _,,2.s«f pr • • yZ,. SLA$ A r\) D NOc--crc0(2 o - $ gbo c L$ E /I2 24if IOTA L.- 14 a'ce,e i i -------------- - �_, -{Ea_ 2'-\" UL - 3 vse ' ________r_ i;1-P,T-7 All----€:--' '' __ ..,...., 0- L_______, ,,_,_, ___› 1 ,----. F _ ..___ ----- ---______ 2 x-►4