768 AQUATIC DR - FNCE20-0097 Building Permit Application Updated 10/9/18
{ City of Atlantic Beach Building Department **ALL INFORMATION
~ 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
uxt� IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us _ _
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Job Address: .08 1!`G f l i Vl't 1/�, AikL B PC d&Permit Number: FNCGZo cX f 7
Legal Description 7uet:fl L __. ..�✓,t y44L $"GG". RE# 7!g,i j"S L 710
tkoo,R t t420 L� T I ov
Valuation of Work(Replacement Cost)$ `'� 3(o Heated/Cooled SF Non-Heated/Cooled
• Class of Work: [tJew Addition ❑Alteration ❑Repair [Wove Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial 71Residential
• 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:
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akiej ►f'fJIetre f0t1 Cc liVatur-d p / pe4.
Florida Product Approval# for multiple products use product approval form
Property Owner Information�� (� {� 41102-k
Name �r(, ►1�[/f✓ I' LIMA`�IM�114 1 t,V ✓Y\S Address B
City A 0 Z is State Zip 3 z Z Phone 1O4 SG'g 340g
E-Mail g tAY)(t iMeAC \ I SO c.ut'lA •tier
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company ( (° 1 ('S Qualifying Agent C, T1 e}a v C vet
Address City JCiC.IL`20)AV lit State Zip ,.j2.2--2-`J
Office Phone 0 Li 5t)S 94 S Job Site Contact Number
State Certification/Registration# E-Mail +'lCe Slog g yp G i.a..1.l • t
Architect Name& Phone#
Engineer's Name&Phone# 1 r/ fi°40 itt l . CD.
Workers Compensation Insurer OR Exempt❑ Expiration Date c,//p/2o 2-
Application
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 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.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with 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 FINA_ NCING, CONSULT WITH YOUR LENDER OR AN A ORNEY BEFORE
RECO: ' V. • NOTICE OF COMMENCEMENT.
AO/ AIL
ure of Owner or Agent) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this day of �ed a{�d swp4to(or it p-.) beforeAiais day of
elf M 2c La,b ,C ZO,b
1 ivd_JalL Al
(Signature of Notary) ur-
Personally Known S';Zo��`�eO ERIKA SLAWSON [ 1 Personally Known OR s�' "t"�, TONI GINDLESPERGER
Notary�ullic-State of Florida
[ ]Produced Identifica i` [ ]Produced Identification *: • MY COMMISSION#GG 353178
• � fi`; Commission N GG 2A6725 Type of Identification: '+�
Type of Identification: or ti:' VP �v\'� r
I F�of n?, 2023
Bonded through National Notary Assn. , •, BondedThtu Notary Public Underwriters
REVOCABLE ENCROACHMENT AGREEMENT
(7:-
City of Atlantic Beach **ALL INFORMATION
Y 1 -1 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
v � IS REQUIRED.
REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and
existing under the jaws of the Statepf Florida, hereinafter referred to as "CITY" and
l/`u rZ'1+ S �( c-(Aild_ J 5 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 , �,v,�v `, �-t Pc_,A-c.� (` ^'cL
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 C4- aJ'4--1"<< () 1,) , ,* 74.✓t^' r'c Av' ( , (-
• 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
liabili "i.are herby assume by the US .
--A- 14-7 (/ Date 9 S(p ZO2 0
Propert Owne gent(sj ned in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL (_ ;1 f
The foregoing instrument was acknowle ed this /' day ofQ15---1 , 20 C C ,
by-- t l :> hP� t `\ lC't _f'~ "C , who personally appeared before me and
(printed name of Signer)
ackledged at h /she sig ed the instrument voluntarily for the purpose expressed in it.
i"..
C� F ".` Department Approval:
l iS :!,,,c, TONI GINDLESPE :'ER
Signature of Notary Public, St.te of Florida '' E*.:;'", •y MYCOMMISSION iiGG3S3178
[ I Personally Known =
ivi Hr ori u vvi i u bU K Vb Y Uh :
LOT 19D, AQUATIC GARDENS, AS RECORDED IN PLAT BOOK 38, PAGES 71 AND 71A
OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA
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PIPE (PLS 1576) S82�43 (93.40
TRACT 3 SEWERS
T FOR pRAINAGE, U�EITIES AND
EASEMEN
VOTES:
NOTICE OF COMMENCEMENT
State of i jf OA Tax Folio No.
County of DovvkL
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: 3 - 7/ ( 7 ' ZS- 216 A00,4AL d-OeNS Lar ,c-
Address of property being improved: 76i1 AA lh17fG 'b e(J tt ri-74-A-'''-Pc gebi fL- .322 33
General description of improvements: ,6 Ell'S7;,•)41 SNL&
Owner: 1'A^{IAI✓ 1 SJ mum Moths Address: 1"Y 4 ) -k- ' e . krt.-milt Sal, ti 32133
Owner's interest in site of the improvement:
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Fee Simple Titleholder(if other than owner): 0c z o 3
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Name: o-< a -oN
2 Cr
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Contractor: PEN it( C wog- 0 N w
Address: 131%i/..- GB-rtOL Cr. JMo � 332,225- o F 0,N
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Telephone No.: 5o4,-- 5.6a' Zt Fax No: xi
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Surety(if any) (> w
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Address: Amount of Bond$ c
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Telephone No: Fax No: 0
Name and address of any person making a loan for the construction of the improvements 7 o
Name: 0
D
Address: 1—
Phone No: Fax No:
Name of person within the State of Florida, other than himself,designated by owner upon whom notices or other do.
be served: Name:
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: a
'��.�4',: SCOTT P DAVEY
Telephone N da Fax No:
e: Commissio GG 341534 .
Expiration date of Noti e''a.. 0 m,m�Egp�grit e��x irki? date is one (1)year from the date of recording unless a different date is
specified): __ — _ _ __--
THIS
_THIS SPACE FOR RECORDER'S USE ONLY OWNER
State of Florida,County of Duval /(��yti x/2.5 f/240
Signe.: Date:
SW n to.nd Subscribed before ii• this d81 Before me this Z day of S {!rtor34. .e in the ounty of Duval,State
of • ,20 Z-���
Of Florida,has personally appeared�.7�Y1A,INA-4.-v- �• ,"�'(/ei 5
Notary / Notary Public at Large,State of Florida,County of it:L Duval.
Nota Public �'4 . My commission expires: // /
4
State of Florid. Personally Known: or
My commission expires ---7 FL,120�� Produced Identification: �l, O K-1� I-( 4r,y(
Personally known( I or produced identification Of