Selva Marina-1600 (14-0940) Golf Cart ShelterCity of Atlantic Beach
Building Department `
r 800 Seminole Road SUN 12 2014
Atlantic Beach, Florida 32233-5445
"^ Phone (904) 247-5826 • Fax (904) 247-5845
E-mail: buildin de t@ coab.us
9- p
City web -site: http://www.coab.us
APPLICATION NUMBER
(To be assigned by the Building Department.)
Date routed:
APPLICATION REVIEW AND TRACKING FORM
Property Address: /
& UQ ��/V"a' -727a n -;'1
Applicant: �/'S 61)6rrac4id 0
Project: '� L lC•e,J
�X/
Departm.prit review required Yes No
Buil
tannin & Zoni
ree nistrator
Public Works
ublic lities
ublic Safety
ire rvices
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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
Revised 05/14/09
Reviewing Department
First Review:
Approved.
❑Denied.
(Circle one.)
Comments:
BUILDING
PLANNING & ZONING
Reviewed by:
I
Date:
TREE ADMIN.
Second Review:
❑Approved as revised.
❑Denied.
PUBLIC WORKS
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by:
Date:
FIRE SERVICES
Third Review:
❑Approved as revised.
❑Denied.
Comments:
Reviewed by:
Date:
Revised 05/14/09
PUBLIC WORKS PLAN REVIEW COMMENTS
Date: _%—/ T
Initials: PNYi M
Project Name/ Address: / Q 1j i_11(,4 Application Permit #• A 9 z
Check Box
Check
Application Tracking Comments
to Ad
Box to
Comm nt
"Print"
IMPS
Provide table of impervious surface calculations for entire lot (existing and post
construction).
❑
ESCP
Provide erosion and sediment control plans with installation details and maintenanc
,
schedule.
❑
DPLN
Provide drainage plans showing site topography (flow arrows, etc.)
❑
RMRO
All runoff must remain on-site. Cannot raise lot elevation without measures to retain
runoff.
❑
❑
CSMP
Provide construction site management plan, including Right -of -Way Permit if using
❑
right-of-way for construction parking.
TSUR
Provide a pre -construction topographic survey prepared by a Florida Licensed Professional
Land Surveyor, showing 1' contours.
❑
❑
Section 24-66(b) of the Land Development Regulations requires on-site storage for
LDCS
increased run-off if adding 400 SF or more impervious surface. Provide Delta volume
calculations and on-site retention required per Section 24-66(b). (See attached information
❑
❑
sheet.)
PCTS
If on-site storage is required, a post construction topographic survey documenting proper
construction will be required.
❑
❑
RWPM
A Right -of -Way Permit must be obtained for use
❑
❑
REPM
A Revocable Encroachment Permit must be obtained.
❑
❑
PLWP
Pool – Wellpoint (if used) must discharge into vegetated area 10' minimum from street or
❑
❑
drainage feature (swale, structure or lagoon).
All concrete driveway aprons must be 5" thick, 4000 psi, with fibermesh from edge of
DAPR
pavement to the property line. Reinforcing rods or mesh are not allowed in the right -of-
❑
❑
way. (Commercial driveways – 6" thick).
Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be
URCT
overlaid 10 feet in each direction from the center of the cut. Repair must be shown on the
❑
❑
plans.
RWRS
Full right-of-way restoration, including sod, is required.
❑
❑
Roll off container company must be on City approved list and container cannot be placed on
ROFF
City right-of-way. (Approved: Advanced Disposal, Realco, Shappelle's and Waste
1�
❑
Management).
Full erosion control measures must be installed and approved prior to beginning any earth
ECIN
disturbing activities. Contact Public Works (247-5834) for Erosion and Sediment Control
❑
Inspection prior to start of construction.
MEET
Recommend Owner/Contractor meet with Public Works Director to discuss proposed
T
_
❑
❑
construction. Call 247-5834 to make an appointment.
i
0
0
City of Atlantic Beach
Building Department
800 Seminole Road -
Atlantic Beach, Florida 32233-5445
Phone (904) 247-5826 • Fax (904) 247-5845 J U N :' ! ; ! i 4
E-mail: building-dept@coab.us
City web -site: http://www.coab.us
APPLICATION NUMBER
(To be assigned by the Building Department.)
>- ?1140
Date routed:
APPLICATION REVIEW AND TRACKING FORM
Property Address: /& UQ Ji I✓,a, -777a. r% ii
�� C `
Applicant: /�.ST GC.C-�i 0 /n �
Project:'� L •e,✓ E
�2Z/
Review fee $ t Dept Signatu
D ent review required Yes No
Buil
Plan & Zoni
ree nistrator
Public Work
ub is s
ublic Safety
ire rvices
Other Agency Review or Permit Required Review or Receiptof Permit Verified R Date
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:
PApproved.
❑Deni::
(Circle one.)
Comments:
BUILDING
PLANNING & ZONING
Reviewed by:
Date:
TREE ADMIN.
Second Review:
[]Approved as revised.
❑Denier.'.
Comments:
f1PRKS
Reviewed by:
Date:
FIRE SERVICES
Third Review:
❑Approved as revised.
❑Denis..'.
Comments:
Reviewed by:
Date:
Revised 05/14/09
PUBLIC UTILITIES PLAN REVIEW COMMENTS
Date: C 2
Name / Address: 1600 'SO'b.
lnitials:�
- Y V 0
Check Box
Check
Application Tracking Comments
to Add
Box to
Comment
"Print"
UWSU
Avoid damage to underground water / sewer utilities. Verify vertical and horizontal
location of utilities. Hand dig if necessary. If field coordination is needed, call 247-5834.
MBSC
Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible.
❑
❑
RTIC
A sewer cleanout must be installed at the property line. Cleanout must be covered with
an RT1 concrete box with metal lid. Cleanout to be set to grade and visible.
❑
❑
RPZB
A reduced pressure zone backflow preventer must be installed if irrigation will be
provided or if there is a private well on the property. Backflow preventer must be tested
❑
❑
by a certified tester and a copy of the results sent to Public Utilities.
STRM
Plans note the building will be unsprinkled. If plans change, any fire line installed must be
metered with a Sensus touch -read meter in a properly sized vault and an appropriate
backflow preventer installed. Backflow preventer must be tested by a certified tester and
❑
❑
a copy of the results sent to Public Utilities.
FSBR
If fire sprinkler system is provided, contact Malcolm Clemons at 247-5839 for backflow
requirements. At a minimum, will require a double check backflow preventer.
E3
❑
FLM
Fire lines must be metered with a Sensus touch -read meter. Meters larger than 2" must
be installed in a vault as noted in JEA specifications.
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
13
0
BUILDING PERMIT APPLICATION `X"Y ` ''' `' r"
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-51145
Job Address:(C C,` > GI i � A 11V1a t l & Permit Number:
Legal Description 1 (nto ! u/f �rf�--�,' n!1� 0t2-iy 2.,� Parcel #_
� Floor Area o q. t.
Valuation of Work $ 3 Proposed Work heated/cooled
non-heated/cooled r
Class of Work (circle one): Nee Addition Alteration Repair Move. Demolition pool/spa window/door
Use of existing/proposed structure(s) ((circle one): Com�ercia Residential
If an existing structure, is a fire sprinlrWr system install ne): Yes No /A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: 6rlsr72"C-
Propertv Owner Information:
City 1/
E -Mail or Fax #
Contractor Information:
�_5?r9 3 Phone %✓:��— ��>t'= -
Company N me: C..1C�- C Qualifyin Agent: r r.
Address: City ^ State Zip 3z;260
Office Phone Job Site/ Contact Number -? Fax #
State Certification/Registration #
Architect Name & Phone Z
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation lugs commenced prior to the
issuance. of a permit and that all work will be performed to meet the standards of all laws regulating con,strGction in this jurisdiction. This permit becomes null
and void f work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a_ period of six (6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters,
Tanks ar ul Air Conditioners, etc.
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 RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined thispplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or local law regulatin construction or the performance of construction.
Signature of Owner /'C
gn Signature of Contractor
Print NamePrint Name
Klcg
....e�e. -.........................................
Swoto and sub
this Day of
me
- 8tdo of FlaWa
otary Pubis o ary Public '?N Commission d EE 102894
�a r^! ."P•; CHRISTINA P. CARLSON
MY •8ondedjhjojUiiXjI r
83
EXPIRESMNovember25, 2017
os 4d ' Bonded Thru Notary Public Underwr&ers