765 Sabalo Dr FNCE19-0138 4' r1, ''>> FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
t. ' ..` ",' FNCE19-0138
¢ '4- ' CITY OF ATLANTIC BEACH
�� `�`
800 SEMINOLE ROAD ISSUED: 12/11/2019
Lt;iW• ATLANTIC BEACH. FL 32233 EXPIRES: 6/8/2020
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: i PERMIT TYPE: DESCRIPTION: ` VALUE OF WORK:
765 SABALO DR FENCE WALL OR BARRIER FENCE 4' FENCE $500.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171303 0000 ROYAL PALMS UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
OWNER: ADDRESS: CITY: STATE: ZIP:
WYLIE MICHAEL 765 SABALO DR 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 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.
3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
Issued Date: 12/11/2019 1 of 2
mss--Lir,, FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH FNCE19-0138
ISSUED: 12/11/2019
800 SEMINOLE ROAD
�Ji3 �r ATLANTIC BEACH. FL 32233 EXPIRES: 6/8/2020
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.
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:$81.50
Issued Date: 12/11/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
0� 1 Y, - Building Department (To be assigned by the Building Department)
r ;s 800 Seminole Road FKKE
f C� — , C7j -e Atlantic Beach, Florida 32233-5445 t ( �)
Phone(904)247-5826 • Fax(904)247-5845
.r n s)$ E-mail: building-dept@coab.us Date routed: l Z
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: / s
A6• <� Department review required Ye .- No
0 :uildinq �/
Applicant: (4) k)E---(2__ manning &Zoning ,
Tree Administrator.
Project: 4 e.-_,...) a G ub is or s _
•Public Utilities
Public Safety
vire 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: 1 Approved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: Date: 2 '2' /
TREE ADMIN. Second Review: nApproved as revised. ❑Denie . ❑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
�,i,:Ly;.� City of Atlantic Beach APPLICATION NUMBER
js . Building Department (To be assigned by the Building Department.)
11
;.f' 800 Seminole Road j I Q
�0 Atlantic Beach, Florida 32233-5445 ` N ` rO C�
Phone(904)247-5826 • Fax(904)247-5845
^�r; �? E-mail: building-dept@coab.us Date routed: I I Z
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: / (oS ` A6 L _ Department review required Yes No
Lidding
Applicant: boj\] (�_ Winning &Zoning
_ Tree Administrator.
Project: 4 E a- C_ tub�c►�Po '
_ hlic Utilities ^h
Public Safety
'=ire Services
Review fee $ Dept Signatur€.
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 r
PLANNING &ZONING Reviewed by: — Date: 12_L-- 9
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
City of Atlantic Beach APPLICATION NUMBER
(1J
Building Department DEC ��, (To be assigned by the Building Department.)
r, .' 800 Seminole Road �Ud� f )c.gCP
C�
j� ;0 Atlantic Beach, Florida 32233-5445 ..
Phone(904)247-5826 Fax(904)247-5845
�,It �? E-mail: building-dept@coab.us Date routed: i 1 z
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: l (S R 6• L K' . ri Department review required Yes No
uildinq
Applicant: 0 L3 to _ fanning &Zoning
Tree Administrator
Project: 4' a-ki ac, (15-ub is ol`�res ,
,--Public Utilities''
Public Safety
wire 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. 1 f Denied. ['Not applicable
(Circle one.) Comments:
BUILDING
,
PLANNING &ZONING Reviewed b Date:,?.%J-/
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. fNot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
S.AP.1; r, City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
• i) 800 Seminole Road /`�
j, 0 Atlantic Beach, Florida 32233-5445 �N c -o C�
Phone(904)247-5826 • Fax(904)247-5845
r � E-mail: building-dept@coab.us Date routed: I Z t
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: / ACJ• Department review required Yes No
• :uildinq
Applicant: 0 (A) i\o c-42._._ Tanning &Zoning
Tree Administrator.
Project: 4 G L9 C`G Public vtrorks'-,
rPublic Utilities 'h
Public Safety
ire Services
Review fee $ -ROWS 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:
APPLIC ON STATUS
Reviewing Department First Review: Approved. 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
rt ' Building Permit Application OFFICE COP Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233..,f ) HIGHLIGHTED IN GRAY
o9,- IS REQUIRED.
Phone: (904) 247-58261 Email: Building-Dept@coab.us C
Job Address: (043-I -e Q /IC��,1' a✓' Permit Number: r i ce 1 q -61 3 Sal
Legal Description L.0-4- g3 B4 --k 1 Rove' P4.I►v't�j RE# 17 ]7j o '3-0000
Valuation of Work(Replacement Cost)$ 6a7 . Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New DAddition ►:lI,Iteration ❑Repair ❑Move ❑Demo ❑Pool DWindow/Door
• Use of existing/proposed structure(s): ❑Commercial (Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes iNo
• 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 b performed:
Florida Product Approval# -_ for multiple products use product approval form
Property Owner Information
Name /14 %. k, w� �, Address --/( S-- -�0 �l.
City 44- (c .I'c- k State tL._ Zip 3 Z2-3-7, Phone ICI - I-1 S -OZ:71>
E-Mail 0Y1.(_t9 v r1 "c. erS 0 vv-‘,:x_i I . c_e"....--t
Owner or Agent(If Agent, Power of Attorney or'Agency Letter Required)
Contractor Information
Name of Company Qualifying Agent
Address City State Zip
Office Phone Job Site Contact Number.
State Certification/Registration# E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt 0 Expiration Date
Application is hereby made to obtain a permit to do the w and installations as indicated. I certify that no work or installation has tV
`O
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIG S,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requirements of this N
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county, and Q O
there may be additional permits required from other governmental entities such as water management districts,state agencies,oIz F- V
federal agencies. 0 a w
Z La
AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all LZ 0 .
applicable laws regulating construction and zoning. Q a
az
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY : o a
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND' z
TO OBTAIN FINANCING, CONS LT WITH YOUR LENDER OR AN ATTORNEY BEFOREu. . tii
-,
RECORDIN YO ' NOTI E • OMMENCEMENT. ut '" `'� Ca
�'
/ ; O W
( :nature of Ow •r or Agent) (Signature of Con .ctor) u) u1
5 CC W
Sigrined and sworn to(or aff -2 C ► I'b-;t r? m;his .ay of Signed and sworn to(or affir ••d)before me this y ofiii
cc
J\ c:J ,W b.isw,
' , .
W° : a rre of N7s11111)� (Signature of Notary)
Al
[ ]Personally Known OR ;ip}"�'`• .I TONT GiND Z.:,Fi —" n OR
[ ]Produced Identification ;*c "` ;.: myGOMMISSI(b 'r"Ode
t i( ification
- ( ;• ,9 EXPIRES:Oct t, ''iType of Identification: i ic. ion:
'f." Bonded Ther N Pubic Underwiters
yfliv, Owner Builder Affidavit **ALL INFORMATION
p*. . 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#:
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-DEPTPCOAB.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(o � 110 ck,,'- 44 t- (a-v,4 ‘N L Ll 3zZ3
Owner Name: YV\c Wlttr `._ Phone Number: 4 (q - 9,3-5-- (j22i)
Mailing Address: Sc w►� ct.5 G. (.J& City: 041, b ea %' , State: Zip:
Notarized Signature of Owner RA4
Thegoing in rument was acknowledged before me th. 27day of I VQt/ , 20L c the State of Florida, County
of V'a
Signature of Notary Publ' ,a ,......a.jcr)
-
[ ] Personally Known OR [ ] Produced Identification /
Type of Identification: 40 0 - SS OL- (,0 — 3 3 0 -
r ' Updated 10/24/18
'°•''' TONI GINDLESPERGER
'.; p ;*: MY COMMISSION#GG 353178
;o`•= EXPIRES:October 6,2023
r .FFO ;°,%' Bonded Thr,Notary Public Underwriters
PUBLIC WORKS PLAN REVIEW COMMENTS Date: /o " Application#: //1/Z.,g / 7"" .47 3k
Protect Address: 76 �J -�/6a,
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).
Erosion Full erosion control measures must be installed and approved prior to beginning any earth
Control disturbing activities. Contact the Inspection Line (247-5814)to request an Erosion and Sediment 0
Control Inspection prior to start of construction.
Onsite All runoff must remain on-site during construction.
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. 4�
ROW ,.. /
Restoration Full right-of-way restoration, including sod, is required. ICY
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 Maximum driveway width within the City right-of-way is 20'. 0
Driveway
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. ❑
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.
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
Revised 2/26/19
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