390 Main St DWAY20-0005 Concrete . -AJT%'� DRIVEWAY PERMIT PERMIT NUMBER
,6' 'AriDWAY20-0005
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CITY OF ATLANTIC BEACHuryr 800 SEMINOLE ROAD ISSUED: 2/12/2020
4D.Ft19r ATLANTIC BEACH. FL 32233 EXPIRES: 8/10/2020
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:
390 MAIN ST DRIVEWAY SINGLE OR TWO CONCRETE DRIVEWAY $2000.00
FAMILY DRIVEWAY
TYPE OF . REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: I NUMBER: GROUP:
170900 0600 ATLANTIC BEACH SEC H
COMPANY: I ADDRESS: I CITY: I STATE: I ZIP:
South Edge Construction 14333 Beach Boulevard Suite 33 Jacksonville Fl 32224
OWNER: ADDRESS: CITY: IMMO ZIP:
WEST GROUP 623 MAIN ST ATLANTIC BEACH FL 32233-2530
ACQUISITIONS LLC
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 DRIVEWAY APRON INFORMATIONAL
Notes:
All concrete driveway aprons must be 5 inches thick,4000 psi,with fibermesh from edge of pavement to the property line.Reinforcing rods or mesh are
not allowed in the City right-of-way.
Issued Date: 2/12/2020 1 of 2
r �S� r
'''", DRIVEWAY PERMIT PERMIT NUMBER
.0 CITY OF ATLANTIC BEACH DWAY20-0005
�rISSUED: 2/12/2020
. 800 SEMINOLE ROAD
.,,401; ii v EXPIRES: 8/10/2020
ATLANTIC BEACH. FL 32233
2 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.
3 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
4 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL
Notes:
Roll off container company must be on City approved list. Approved list can be obtained at the Building Department at City Hall. Roll off container
cannot be placed on City right-of-way.
5 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
6 PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
7 PUBLIC WORKS MAXIMUM DRIVEWAY INFORMATIONAL
Notes:
Maximum driveway width within the City right-of-way is 20 feet.
8 PUBLIC WORKS DECKING REMOVED INFORMATIONAL 1
Notes:
All old decking and debris must be removed from job site by Contractor.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00
TOTAL:$125.00
Issued Date:2/12/2020 2 of 2
. - City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road. i L r, r--
_,:K.,
-
Atlantic Beach, Florda 32233-5445 L, � zO 0005
\ Phone(904)247-5826 Fax(904)247-5845
-"!�;t>>%' E-mail: building-dept@coab.us Date routed: Z 0
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3H 0 1\ \ pt (N (- , t Department review required Yes No
Building
Applicant: , O v 7 C—( C De,E C O(3 ---c fanning &Zoningg
Tree Aaminittrator-
Project: C i\J C L(= TE- LJ iZ WE-1.0 A-y AGblic Work�>
• Public Utilities Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By _
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers _
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: pproved. Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: 1— 10-1 C.,
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
/i,,.`-:..', Building Permit Application
: City of Atlantic Beach Building Department l/FdFORM/9/28
800 Seminole Road, Atlantic Beach, FL 32233 HIGH I GHTED IN GRAY
Phone: (904) 247-5826 Email: l,uii(iirt: Ur.r)tk)co�tla._u, IS REQUIRED.
Job Address: 390 Main St,Atlantic Beach,Florida,32233
Permit Number: i .1ikiA`a0- C70Q5
Legal Description 18-34 17-2S-291.117 ATLANTIC BEACH SEC H 1.0T G 11.11(124
--_ ....._.. � RF.ff 170900-0600
Valuation of Work(Replacement Cost); 0 -
-2_._O -Heated/Cooled SF 1122 Non-Heated/Cooled 1406
• Class of Work: r:New CJAddrtion ®Alteration ®Repair DMove r -
::,Demo Cipool %7Windoty/Door
• Use of exlsting/proposed structure(s): C Commercial Oiesidential
• If an existing structure,is a fire sprinkler system installed?: :)Yes No
• Will r- _ s • a,1 r e I.: rl I. I)n wi h Oro seri noir•ct:s
I Wes most suhn)ilse•arat'Tr I( i c vat P inti !ii..
Describe in detail the type of work to be performed:
flO U r Con c 0,Lic 1r C 4,,,
Florida Product Approval 0
_ for multiple products use product approval form
Property taky e_r lnoormatinn
Name West Group Acquisitions I.,I.0
..---,w __.__.__-_.._ ___._ Address 632 main St.
City Atlantic Beach State Florida 7;p 32233 -n e �--`53` ---------�
L-Mail Brandonperrywest(tagmail.cont Phone 9Ur2 537 5790
Owner or Agent(Lf Agent,Power of Attorney or Agency letter Required)
Contractor Information —
Name of company _ South Edge Construction LLC William Mazar - �-
NmeAddress , --- - Quafifyinf Agent
---+m.7d9 sandy creek dr
Office Phone ---- _._._City _1?X State f(—_ 32224-- _
lob Sift Contact Number _7iP _,
State Certification/Registration I: CBC0530-12
H_ —
Architect Name&Phone
Engineer's Name&Phone it _. __
Workers Compensation Insurer __� ,,,__, __ _ _-" �` _' — _____
.. , _ OR Exempt i Lxpiratron Date-
Appliration is hereby made to obtain a permit to do tee work and installations as indicated I-r e till,that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the Latus re3Ulating
construction in this jurisdiction.I understand that a separate permit roust be secured for ELF(1IlI(:AL WORK, PIUfvIRING,SIGNS,
WELLS,POOLS,FURNACES,('BOILERS.I1CA7FRS,TANKS,and AIR CONDITIONERS,etc, NOTICE.:In addition to the rcrptirn;nAnts of this
permit, there may be additional restrict ions applicable to this properly that may be found in the public rC is of GIs 2920iy,and
there may be additional!)ermlil required from other hover nntr•ntal ontilies such as wale,-maeireemenI dlw c .state agencies,or
federal agencies.
OWNER'S AFFIDAVIT:I certify that all the foregoing in`ormatinr,is accurate and that all work will 'done ir,coniuliancc with all
applicable laws regulating,construction and zeroing,
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
RE .1: a I - OTICE OF COMMENCEMENT.
(Signature of()wae,or Agent)
-"-- Ian' of Contracto I
TaSigned and sworn to(or affirmed)before e this --e"" day of Signed and sworn to(or affirmed)be ore'me thi-. day of
.2024_,by
(Sit;uau,r o(* - —��
(Styria dr ✓ .
I JPersonally Kno•.v,,OH
• ' '•• .,, , ,r , i Inc' snnally Known CH
61e ' e
t D r t o f 'aur `L J Prutluccd Identification , 'ii; Thomas Moffett
Y1
r
t)Zt71t,99,r,ossiwwn -,10.. • — ......... Iyr.ofIdant.iiicition: _ a j`'
a > cGCamm.l .GG92�y4�y916�e��
.:,,all to alfIS )Ilgnd AlvioN ,:qt. #C ee Li LVC3
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City of Atlantic Beach - APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
)� 800 Seminole Road
j . Atlantic Beach, Florida 32233-54 r 1U1J .0 LO• L
ZO— 0005
Phone(904)247-5826 • Fax(90 47-5845 / / -
p g ` E-mail: building-dept@coab.us Ry. Date routed: Z/ VZ
City web-site: http://www.coab.us rr /
APPLICATION REVIEW AND TRACKING FORM SWO
Property Address: 39 0 M A( Department review required Yes No
Building
Applicant: �0 0-T ( LDC C Coi
( ar�min�g &Zoning
r\ Tree Aam_=.irii`trator�
1
Project: C�i0 C ae-re jZ l�(te2o A- R blic Wow _
.- Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. Denied. Not applicable
(Circle one.) Comments:
BUILDING
IBJ
PLANNING &ZONING Reviewed by;led"`ida.,;'',lt 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. I 'Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
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r?,, REVOCABLE ENCROACHMENT AGREEMENT
City of Atlantic Beach "ALL INFORMATION
''`rHIGHLIGHTED IN GRAY
Vlir 800 Seminole Road,Atlantic Beach,FL 32233
IS REQUIRED.
' lint
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 "USER".
WITNESSETH:
That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon
the property for the purpose as described in the City of Atlantic Beach.
This work is generally described as
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to
relocation or removal on thirty(30)days'notice by CITY to USER,said notice to USER shall be given by certified mail, return
receipt requested, to the following address 390 OVA ,5 , ; .414,- gccr /3zzD3 .
l
• In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter
upon the above described easement or property of the CITY, the USER shall replace at the USER's sole expense,
any and all material necessarily displaced during the action of maintaining, repairing, operating, replacing or
adding to of the utilities and facilities of the CITY or franchise utility provider.
• The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land
Development Code and all other land use and code requirements of the CITY, including City Code Section 19-7(h)
which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must
be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks."
• The USER, prior to making any changes from the approved plans and/or method, must obtain written approval
from the City of Atlantic Beach Public Works Department, for said change within 30 days after the day of
completion.
• This permit shall inure to the benefit of, and be binding upon, the USER and their respective successors and
assigns.
• USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or
specifications, to include utilities locate requirements and use limitations/requirements of easements, public
right-of-ways and other public land. USER further agrees that the CITY and its officers and employees shall be
- saved harmless by the USER from any of the work herein under the terms of this permit and that all of said
'atm %'-s ar h y assumed by the USER.
-
`r. Datt�':3 —z-D
Property Owner/Agen (signed in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL
The fore Ing instrument was acknowledged this Q day of le,...‘. ,20' ,
by AeNt. 1 ovr-,0/'\ ,who personally appeared before me and
(pri ted name of Sig ter)
acknowledged,that he/she signed the instrument voluntarily for the purpose expressed in it.
C •ussy dtetoN IeuoneN 46no14l PaReoB
urn't unr sotldx3' )AW unito) , u3pL': Department Approval:
Sig ature o Notary Public,State of Florida ttl9Zt'JDti s.vindAni ;.'?(„..W).:4 ` /A
ePl tol3)o atet5• AVIV �t�etttN \i44.\..
, \ , ` .
[ J Personal) Known (', N7Wa0DAWv ..!?�►v±`a /
(pQ Produced Identification(Type) _ C_ "— __ �'
_. Scott Williams, Pu li orks Director
M:\Applications&corms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
--i +r RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION **ALL INFORMATION
A`' " City of Atlantic Beach HIGHLIGHTED IN GRAY IS
_ 800 Seminole Road,Atlantic Beach,FL 32233 REQUIRED.
'°T`o7,t,Y
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address 3(10 !r Knirt 9 A 1orv�,C 1?,, tt f 32233 Permit Number DWA112o - 6005
Contractor Information
Company South Edge Construction Qualify g in Agent William Mazar
Address 13749 sandy creek dr jax fl 32224
City State Zip
Phone 904-697-8049 Email info@southedgeconstruction.com
State Certification/Registration# CBC053012
Architect Phone Email
Engineer Phone Email
Workers Compensation Insurer OR Exempt r1X. xpiration 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
Christopher Carvajalalsupervision of [Protect uperintendent)South Edge Construction 904-697-8049with (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
expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges.
• he Public Wor s Director e no d 24 hours prior to starting work and again immediately upon completion.�
6k 6A
5 "---..,,.. Date Z--1 —2 0
Permittee(signed In presence of Notary Public
STATE OF FLORIDA,COUNTY OF DUVAL -7
The foregoinginstrumentwas acknowledged this ? day of -re{,/11 ,20,-2,46 ,
by 1 `0A _ ,w o personally appeared before me and
(printed name of Permittee)
fy�w"'I AMY GORMAN
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it, ,' 1' Notary Public.State of Florida
r ,y?.!'JF/ Commission k GG 2267111
•.''.!ti.r. My Comm.Expires Jun ,2022
Bonded through National Notary Assn. •
[ )Personally Known
Slfnature of otary Public,State of Florida Produced Identification(Type) a.
H:\Applications&Forms\Word&Excel Document Originals\201801001 Right-of-Way Easement Permit ApplIcation.docx Revision Date:10/1/1N
't;.f lri;> TREE & VEGETATION AFFIDAVIT FOR INTERNAL OFFICE USE ONLY
'' • nt City of Atlantic Beach
A 15 Community Development Department PERMIT#
800 Seminole Road Atlantic Beach, FL 32233
Jt (P) 904-247-5800
SITE INFORMATION
ADDRESS S )L) l 61)// 5 1 / I -1 1L -3Z-z -33
SUBDIVISION A4i4✓14-1 )C4t 1-1t'c- f/— BLOCK Zy LOT
RE# / 7 Oc1o o - (DC d< e RESIDENTIAL f] COMMERCIAL fl OTHER
APPLICANT INFORMATION
NAME
PHONE#
ADDRESS CELL#
CITY STATE ZIP CODE
EMAIL OWNER ❑ 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 HE EB ERTIFY HAT ALL INFORMATION PROVIDED IS CORRECT:Signature of Property Owner(s)or Authorized Agent
SIGNATURE F APPLICANT PRINT OR TYPE NAME DATE
SIGNATURE OF APPLICANT(2) PRINT OR TYPE NAME DATE
Signed and sworn before me on this day of a) by State of jtxtc.jte,4
y
County of ..iC
Identification verified: 1 f(_•,
Oath Sworn: Yes LI No tiTpv o'"••. AMY GOWAN
Notary Public•State Florida
a� { •6, commission r GG 22b111 Notary ignatur �•�
a.r3� Ny Canm.Expires Jin 7,2011.
Sanded in National Notary Assn.
My Commission expires t}A,(f
04 TREE AND VEGETATION AFFIDAVIT 03.01.2018
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-ALL ANGLES AND DISTANCES SHOWN HEREON ARE BOTH RECORD AM)MEASURED UNL F.SS OTHERw,
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The survey nsep d. report Pr the copies thereof are not valid without the digital elpneeure brs..! ,, .•., ,
Florida licensed sturveyebr end mapper
Dote of Field Work: 11 05 2019
Drawn By Oleg
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Order 0 71706
Last newslon Dare 11 L15 2019 . -;
Boundary Survey p•ndarcci by Lets 1 3.a
NexGen Survey nrj LA C.
5601 Corporate V1f,..y, Sun. M10.1
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MAP 5H(31MN;QPLAN OF
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As RECORDED IN PLAT HOOK4. PAGES d4 or 11.1E OMEN?PUquC RECORDS OVVRL couNTr, FLORIDA.
FOR4_ .04ins PI.O IuA CLASSIIIC likONES
BEARIN0 R C£,KA72 4O' efi RIOli11;3F V IJNEF EREOif S AS SHOW4 ON THE MOW MENTIONED PUT.
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FLOOD 71f'1CATE:iHE tat sH00 ;liER[pt. IS IN FLOOD PREPARED BY:
ZONE if` AS SHOWN. Tt4E` O9' Sr1RANCE RATE
WAP• daia:NrTr liA Na. 12ao'� -'n r:;b do 4-11.091. CIARSON ANL) ASSOCIATES, INC.
DATE; MARCi�J 2$ 1997, PROFESSIONAL. LAND SURVEYORS
1643 NALDO AVENUE
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