1826 Tierra Verde Dr FNCE20-0017 6' FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH FNCE20-0017
800 SEMINOLE ROAD ISSUED: 3/9/2020
`F 9. ATLANTIC BEACH. FL 32233 EXPIRES: 9/5/2020
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:
1826 TIERRA VERDE DR FENCE WALL OR BARRIER FENCE 6' FENCE $1650.00
TYPE OF REAL ESTATE BUILDING USE
CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION:
169542 5054 SELVA TIERRA
COMPANY: ADDRESS: CITY: STATE: ZIP:
COAST TO COAST FENCE 1221 GALAPAGOS AVE S JACKSONVILLE FL 32233
CO
OWNER: ADDRESS: CITY: STATE: ZIP:
FREEMAN WILLIAM 1826 TIERRA VERDE DR JACKSONVILLE FL 32233-4527
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. Approved list can be obtained at the Building Department at City Hall. Roll off container
cannot be placed on City right-of-way.
Issued Date: 3/9/2020 1 of 2
,.. FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
f21:,4,,-',,.s �, CITY OF ATLANTIC BEACH FNCE20-0017
>,� Vr 800 SEMINOLE ROAD ISSUED: 3/9/2020
"U'; 9 ATLANTIC BEACH, FL 32233 EXPIRES: 9/5/2020
3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
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.
6 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
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: 3/9/2020 2 of 2
0),API-yir, City of Atlantic Beach " APPLICATION NUMBER
.J . Building Department (To be assigned by the Building Department.)fs) 800 SeminoleRoad MAR 0 4 2020 FN C C-`C ZO- .�\^l
\„ � AtlanticticBeach, Florida 32233-5445
Phone(904)247-5826• Fax(904)24 5
,t"._w�j E-mail: building-dept@coab.us BY: Date routed: / 3 Z
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I t Zc L I Ct2 V coo G Department review required Yes No
)
Applicant: (__ops f ) Cor anning ZoningTh
Tree Administrator •
Project: (a
Pilities .
Public Safety
Fire Services
Review fee $ MPRIPIP. Dept Signature MI
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. I 'Denied. Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING .►. l I
Reviewed b i,.c/ �, _ Date:,14,r2i
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
0!..A4-0 City of Atlantic Beach APPLICATION NUMBER
61 OAKBuilding Department (To be assigned by the Building Department.)
800 Seminole Road / ,� `t
j Atlantic Beach,Florida 32233-5445 FN c F ZO`L/v \ /
Phone(904)247-5826 • Fax(904)247-5845 •-3/ 3 / C)
�1319'? E-mail: building-dept@coab.us Date routed: 2
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I B ZCo ER--P-Pt VEcao C- Department review required Yes No
uildin"�
Applicant: � PAST ` r) e0r � e - `s anr' Hing &Zoning
Tree Administrator
Project: C0 rE3C-E.- . '_ ' •
big 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. I !Not applicable
(Circle one.) Comments:
BUILDING 3 '+1
PLANNING &ZONING Reviewed by`� � Date: "ZG
TREE ADMIN. Second Review: El 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
;ii ii- City of Atlantic Beach APPLICATION NUMBER
lel
ii4 ci, Building Department (To be assigned by the Building Department.)
800 Seminole Road � l /
Atlantic Beach, Florida 32233-5445 FN Q C -ZU—w
Phone(904)247-5826 • Fax(904)247-5845
:Mire ire E-mail: building-dept@coab.us Date routed: /
Z
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I B Z2 ( l&lap V ER..O C Department review required Y1/es/ No
wilding�
Applicant: C) iy) COf�1S( 1—�(J - ming&Zoning
(.._)C)
Tree Administrator
Project: �D (
�F l\)CE—
'lih1iE 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: roved. 'Denied. nNot applicable
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING Reviewed by: / " Date: 31W2-C)V
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 r1 jri.. OFFICE COPY
�� Building Permit Application Updated 10/9/18
J-;- City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
--wit).-
_)
o;t�' IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us i t /� �/� /
Job Address: 1gz(.0 L(EIL �-{Zt b
r � Permit Number: e CC--Z W( 7
Legal Description 3`3- 2$ O1- AS- d.c?L SC-Lv>4 7"I E JZJA- 107Z-7 RE# I(ot354/2-.s-e.)}y
Valuation of Work(Replacement Cost)$ f(O$ ) Heated/Cooled SF Non- Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ❑Residential W
0 ry
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No Z rn
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tr e Removal Permit)'-1]• 10 i IN
,>1.
in detail the type of work to be performed: Sj Feet (0--i- h( c Uz . J Li. `'i .
• LL9 2 0
O ca tz M
t) �) O8 0
Florida Product Approval# for multiple products use product appt44o , i
Property Owner Information 0 d O Q
Name W/LL/AM EIZE-CMf4i1 Address / Z4 T t2/2 4- v ej 1)2- U A
City 47} .-a A !G .(ji f State FL, Zip 32133 Phone (fir,/ Zi.../Q- Z72t < 1•-: r
E-Mail I.L. '4^
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) ill
° 9.
w _W m
Contractor Information f- �J 5 0
Name of Company CO- -T W C c)a i FE'riCe Co Qualifying Agent 'J.71"/ .. .'-2.-4(_, ,S 3 "." ° ti.I
t0i 10.4 L'Ai f ki> Avi 9 city ATC - 6c / State $ - Zip 3z?'3 3 t w
Address >
Office Phone 90 71 '770— Job Site Contact Number / w
State Certification/Registration# E-Mail (-7 )C Iz: A c- _6 '`"I`" ( `- , (.::' CC
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt Expiration Date 7 '11 '202)
Application is hereby made to obtain a permit to do the work and installations as indicat d. 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 standards of all the laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. 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 w ErrnEhiiricts,state agencies, or
federal agencies.
C
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that orMAR be eho12 o iance with `r cl 1
cc applicable laws regulating construction and zoning. J ��LU Lu o i
w 0 Cd
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE$ CE NT MAY R
LLJZ 0 d
__. O 9.
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTE U ° 1
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE .2 o a
RECOMNMOUR NO OF COMMENCEMENT.
(Signature of(Owner or Agent) (Sign../e of Contractor) /., 1°;
Signed and sworn to(or affirmed)before met oZ (day of i ned an sworn to a ed)bef his day f•':••..i y•
R'2Li-4 ,o7.C)( yf' ikk.I i},-, 2L't*/k4 a1- ZO , ! 43",4AM p 15 ,
c
ZZOZlSu6p saiidx3v...tt ,Signature of Notary) _ C4-Sigur 'of . a
94914L JJ uoissuwoo An a
ass ileo a euagoa : $
27 Ver a qn tielo M�+ . .
[ tPer o al�y I�nownNOR �J Personally Known OR • ER
•ro.uce. I.enti ication [ ]Produced Identificatio '• /0; ':
: •;
'I ,., M'r01J11RIStd.i,:.iiw 353178
Type of Identification:fi- DC_ FESS 920- 34^304-0 Type of Identification: f: ' iF'
r! 2C?er F,r,:i.,, r u;L:,.,,P .
, I�erwriters
t v,, City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
~ s 800 Seminole Road
72) _ Atlantic Beach, Florida 32233-5445 FN C( ZO—00 \ /
Phone(904)247-5826 • Fax(904)247-5845 • � 17 C)
�(131 ? E-mail: building-dept@coab.us Date routed: / C�
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 B GC.° 1 1 E1 VEc ° Cartrnent review required Yes No
} .ing
Applicant: c7pra-____LiDa_81_49nTridTh
Tree Administrator
Project: CO rvC Wo
UtilitTer
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. of applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: '` Date: L7—r: 2¢�
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
. . REVOCABLE ENCROACHMENT AGREEMENT
(„---
41, •
� 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
CJJa574" kj 1 r W -F-&,z,zaz_ 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 describedre.446z.
in the City of Atlantic Beach.
This work is generally described as 0 B-1-f5.4*-LI c...-el ".20-\. .
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 / (o Tr6-,26¢-1/ 2cje- .
• 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 'he work herein under the terms of this permit and that all of said
liabilities are hereby assumed by the '
—� �—' / 3/../ZCI
_ Date �
Property Own gent (s gnee in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL _
The foregoing instrument was acknowledged this %,-._ day of 1\1\,C4t 1k, , 20 Z
by" \Jo"JA-.r-t-i -A) ADL 61 v I S- ,who personally appeared before me and
I (printed name of Signer)
ackry ledgethat he she signed the instrument voluntarily for the purpose expressed in it.
v Department Approval:
Sign re of No .ry Public,S ate of F orida 1 ..,".(4,.. TONI GINDLESPERGER 10 '' ,.Personally Known . ', : MY COMMISSION#GG 353178 -' . r
[ ] Produced Identification (Type) vr,, off;' EXPIRES:October 6,2023 Slott Williams, Public Works Director
r� ",'1.; Bonded Tani Notary Public Underwriters _ 4 n
H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
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ME PROPERTY SHONN HEREON APPEARS TO LIE WITHIN FLOOD HAZARD ZGWE K AS SCALED FROM FLOOD
INSURANCE RATE MAP 1 FOR THE CITY OF �.1,1, ,j'c, FLORIDA. DATED 4I-17-2,4 . AND
IS SHOWN AS A COURTESY ONLY AND DOES NOT CONSTITUTE A C R17FCATICW OF SAME.
TRI-STATE LAND SURVEYORS, INC.
8411 BA YMEADOWS WAY SUITE #2, JACKSON V1LLE, FLORIDA 322.56 (904) 731-7235
LEGEND BEARINGS BASED ON , .l� .. UNE AS SHOWN.
• caw. Har
• IRON CM THIS SURVEY DOES NOT REFLECT OR DETERMINE QWI1ERSHIP.
p r Mnr CAP it cS 4/44) NOT VALID WTHOUT THE SIGNATURE AND THE OThaNAL RAISED SEAL
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FENCE
OF A FLORIDA LICENSED SURVEYOR AND 4MAPPER-
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e atasS Orr GLENN M. BROADSTREET, P.S.M. Na 5814
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(IV RAU&asrA? DATE: 5 "Z4-01 5!A TE OF FLORIDA (LB #4927)