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885 BEACH AVE - ACC20-0022 - t.A4, City of Atlantic Beach APPLICATION NUMBER 1- Building Department (To be assigned by the Building Department.) ) 800 Seminole Road . r� Atlantic Beach, Florida 32233-5445 Phone(904)247-5826• Fax(904)2 845 -.Y , c1^ E-mail: building-dept@coab.us MAR 1 6 2020 Date routed: 3/ �! Z City web-site: http://www.coab.us APPLICATION REV SACKING FORM Property Address: E3 Department review required Yes No Building Applicant: ,RSTL_e- P00 L—G, Planning&Zoning�� Tree Administrator Project: Rv (3 ti Ex(S`r PubTicWork�� P Public Utilities P U E‘1(TCS©L Dcj 1'14-Zc 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: 7Approved. Denied. Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by f 14'7,-...lee4.— Date: J-W%1(0 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 11111,-/- City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Re. 7O z 7 00 Atlantic Beach, Florida 32233-5445 C, C_ Phone(904)247-5826 • Fax(904)247-5845 �I �<�/ 7 0.3 9:- E-mail: building-dept@coab.us Date routed: ( tl G_ City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 8 EEiEj\Q*t /SU C- Department review required Yes No Buildin Applicant: {���� C)0 Planning &Zoning Tree Administrator Project: RweR..... ( L (S`7 `-pubTd.vm- s% n Public Utilities x v e�lurJ ET� Oin>C�, PZ( 0 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: nApproved. enied. ❑Not applicable (Circle one.) Comments: ho BUILDING VII a(/ 'e ; ��h II" t` s f 40-,-ot"f PLANNING &ZONING Reviewed bys`' Date:31-3 -1)....G TREE ADMIN. Second Review: A roved as revised. Denied. pp ❑ ['Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed bye% ? 7 C - Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 g4 '' .,,,= '1,, Building Permit Application Updated 10/9/18 21 City of Atlantic Beach Building Department **ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY `9';��r IS REQUIRED. Phone:" (904) 247-5826 Email: Building-Dept@coab.us Job Address: VA— � /7 C/✓ A., 17- iL/7ii /-L Permit Number: hCQ.ZO 00Z-Z_ Legal Description SEE 4/1 !ft&_z RE# 00 Valuation of Work(Replacement Cost)$ 700 ' Heated/Cooled SF Non-Heated/Cooled • Class of Work: LiNew ❑Addition ❑Alteration Lt1 pHeair ❑Move ❑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: p vtr dV2 0 Ai v/( Cxi 5 f,er 9 dr,v{ i,✓oN Florida Product Approval# for multiple products use product approval form Property Owner Information Name4vWe.D l,.JQi v T NEy Address ST-C ,8 a/4 City 4T 4NrsC /36ACH State /--2-- Zip 3 �3 Phone 6909275 9-0/v,/ E-Mail . joa n ton e_9 ai)beifsvufh , net' . oc))c,(2..-r— Owner 6 Agent(If Agent, Power of Attorney or Agency Letter Required) (`', � Contractor Information .. - �' Name of Company ( 1St/( a•'/> (_�. Qualifying Agent Address 1(5( e' Moraae,^ .ore ft Oc City�GlCkSo^vi I/{ State FL. Zip 3 Z a? 3 Office Phone 90Y - 9 Z- 37 31 Job Site Contact Number 'ay- k;17 - 75V, 7 State Certification/Registration#(_13c 1,15 8c1(00 E-Mail ond(e44 6 CO 5 (pool I . o 1 Architect Name&Phone# Engineer's Name&Phone# - _ 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 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 EcolEivE is of this permit,there may be additional restrictions applicable to this property that may be found in th blic records of this co y,and there may be additional permits required from other governmental entities such as water man mektMlitict,20110 a cies,or federal agencies. OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work willaith all 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 TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDINGYOUR OT E OF COMMENCEMENT. _ (Signa ure of Owner or gent) (Signature of Con ractor) Signed and sworn to(or affirmed)before me -is 1 I day of Signed� `and sworn�to�(or affirmed)before me this i day of ttlAak ,_aOZ,a , by A, I• , (Q. g. I • Twat_ , UJI� , by LN(ll. 4& f !aAitu ' ANGELA`.FAMER /Mtn / / - ' Co:nrt+fission#GG 353447 (S .nature of Notary) .4•:F1;4',, ANGELA R.PARKER KER (Sign. ure of Notary) *• ' ', ANGELA PA G 358447 �p�;' Expire t:.'•3rr�ter 23,20 '; :•: q �� ;` Ex res i\wemt er 2 2023 �':�'o's N;P` •;fx18d Tti'U� �=i0 M1EIM8 600.1ebd010 '� �,C.`• gm�er,e� �y(r�pCp gpp.,�g�, t . . . •, •- FL Or�ver5 l�cen� �1'4Yson A'�'wg' .°°° 7o1 I QC\wc.( UC-12-r)se '-I''''.?4,,, , REVOCABLE ENCROACHMENT AGREEMENT +'. City of Atlantic Beach **ALL INFORMATION HIGHLIGHTED IN GRAY ,; "`"tel � 800 Seminole Road,Atlantic Beach, FL 32233 1/71 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 LbtAM-R b i- . - „jchry pec( 7111,161 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 A-v�,2 INS TAt1/)1/°At cQt/rch. �X I5ti/VC .2 ) ✓6 1.(MY . 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 '3> 6e40,14 /i✓, j4T/ 4i I Td,.' .fQj; TIC— 3-.3h ,„ • 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 liabi ' e 'are hereby , sume by the USER. OGL-tet/ k i X,,G1/� Date Q— :fir ,�.. Propert 0 ner/Agent(signed in presenc of Notary Public) STATE OF FLORIDA, COUNTY OF DUVAL The foregoing instrument was acknowledged this �,S day of - ►r , 20 20 , by--1-6A. ti'l. "1-0Y14-^-1 , who personally appeared before me and (printed name of Signer) acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. ''\(--- r ♦ — --ter — — � ;. �p ., Department Approval: i� SHERRY D.SEVIGNY Signature of N tart'Public, tate of Florida 4 - �j Notary Public-state of Florida •/— , �Personall Known ( , Commission u GG 213140 _//' � �1 My Comm.Expires Jun 25,2022G 1 ---s•At... [ 1 Produced Identification(Type) cott Williams, Public Works Director f,.._ /J 47 H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18 NOTICE OF COMMENCEMENT State of rLc)g.,I,Dri Tax Folio Nov i70Z43-0000 County of D U VA 1- To To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: FT Ho+e l Reservcitor. Kecd �,.�L/ i ) Co1 17"t()Lig /} l '"( LOT zo REe ojR 1cd��'- to44 L'-L O (V\c /4 '.?S•a9f //,frukvrie 4Me.l•. Address of property being improved: KSS /tic 4i4-, -111-a1Nrie f!t't cL 333 General description of improvements: iN5 i i4 LC. 6 R..1 CK Ph1/6XS 0VEP. C.DA/L!1QETC- `F- r) Lep .T) .1 V6&Ac/ 842E610 Al Q u,0 ii Ie,4+ rHHRiWow Tr) LJ o&R -PI UeRLb DR, v6 Owner: )46-I H ' 60/j121)*SORN T©NE Address: 3'g. '` RE}U-i 1)1,6 /912 HIV,r1C� PC-i") FL Owner's interest in site of the improvement:Tp J12PoV 13 RD Ly Cte_6C"KED -DRI 1'G t 2Ay v �G , T/DN GX/sj i p � ghr/9�,/E�Q WALL . I Fee Simple Title of r(i'o er t an owner): Name: Contractor:TyL x.V? CfigcTCEfn6ic )S TLE. 4701_5 Y ,4 yy/Z,S L.L.t. ebYAddress: i 1560 Pl i3 illaKi/V kOrC5i 'D/`, JA-c .so'v 0/zz. 1 FL 3,1-23 r\(- Telephone No.:( J) (D 7" 75-6 7 Fax No: - - Surety(if any) Address: Amount of Bond$ _ Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: /Of Address: Phone No: Fax No: Name of person within,the State of Florida,other than himself,designated by owner upon whom notices or other documents may be served: Name: ,41/1 Address: Telephone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section /// 713.06(2)(b), Florida Statues. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER / Signed: •--- .0/i. /i • ' Date: "'c75S-"O7 C)� Doc#2020058504,OR BK 19137 Page 414, Before me to .'3 .:y of ,�,,A ,.,,A in the County of Duval,State Number Pages: 1 Of Florida, personally appeared Tpp.,r% 1.4.-1 Recorded 03/12/2020 02:23 PM, Notary Public at Large,State of Florida,County of Duval. RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL i' My commission expires: �uvi,t„ 2S 1"20 2 COUNTY rd'•., Personally Known: ( Vi � SHERRY D,SEVIGNFr RECORDING $10.00 Prod ed Identification Notary Public S:acc oT Florida ; Commission x GG 213140 0 iLvvi\ ( ., My Comm.Expires Jun 25,2022 _ ��A .....�• ;' i + 1 1 I 1 1 "CLOISTER CONDOMINIUMS I O.R. 3876, PAGE 450 I M SET X-CUT STUCCO COLUMN ■ ON BULKHEAD 3 STORY STUCCO BONDING S85'32'15'�W 164. ( ) r ��_ � , CONCRETE �� EAVES) 0.7'(87) T■'��-�' ■ BULKHEAD STUCCO COLUMN =o wI o; do WALL W/6'FGF 0.9'(67) n m X157.65' 0) w 10.1"11.11.1123.5' .73'(67) 26.0 6'(aT) + o w ZO D ■r _ :,32'15'W,> z "p crl I _ �O pLAN11 v - II •_' 23 ____ / 16.5 CONCRETE POOL 6.7 ',� II 1' O Y n EQUIPMENT PAD r LA � w �I t.8'(fIT � / �' INGROUND m 'i O W 504'27 45 E ,.s(Bi) �i.00 o' 4 STORY Sill= 1 PoolP- c) 7:1.' NI�, 1 �i , �,. •aoFED Oo30.00' (M) y`'� m BRICKpENCE5 �^— r I� `� fid' �". ,1.3X,.0' 24• EA CAAREA .T' ➢ iGoA�+� I rri 1 STORY �/ r E ONCRETE ROOF mei. GATE BOX O.7' n - A/C PAD L_i 3 1 OUND X-CUT n� 11'1 1.3'(8 STUCCO // BRICK TILE AREA ,6.5 _.fig-�, --i _ ON BULKHEAD A ASPHALT ■ to., GARAGE ■ 2.2'(87) 26.0' e 4FGF t.o'� 4) "C' PAVEMENT - I FOUND NAIL 8 DISC 1� ih��'(ST),illr !: �tiVT �S� I (ply,67 G o'= =G CAS TANK ` STUCCO COLUMN ['ydL7.L�+- CONCRETE l, CONCRETE Q•4' .= ■�' 4"PVC &WALL W/4'FGF BULKHEAD 7.24' SET L&DISC ■ ELEC.:"_METER D . O 30.02:21.111.'_.TO IPZ ..`� 0.6'�'i SET NAIL DISC N85'32'15'E 149.26' (M & n 7 SET NAA(LB 1704) (Ls 1704) I Fri N85' '15"E 7.80' N28'45'57"E CH=13.34 (M) T„UNE of LOT 20, CLUB MANOR 7'14" 11.16' (M) « cH=22.32' (0) Z I p FOUND NNL&DISC p INT—�— I Z �5• 18.23' � ) (PLS 1674) i o � STUCCO COLUMN 1N1f] C,Cy &WALL W/4'FGFI p ooN ,P "PITTS' ASPHALT CRS i � I�� 1 \c rr, PAVEMENT {o ,e"caaR I tOT 20, CLUE MANOR rn - PLAT BOOK 25, APE 62 �" GuTTER p I "' O.R. 15584, PAGE 2113 F. Ito°' gn v ' I T z Iv CORNS OF t0T 20. CLUB I/MIDR 53 I oI o-1,