411 SKATE RD FNCE20-0119 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
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 411 Skate Rd,Atlantic Bch,FL 32233 Permit Number: t1 C-E-Z-v - 0 t
Legal Description 31-16 17-2S-29E R/P PT OF ROYAL PALMS UNIT 2 A LOT 10 BLK 18 RE# 171529-0000
Valuation of Work(Replacement Cost)$9000 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: New DAddition ❑Alteration ❑Repair [Wove ODemo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial iResidential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes ❑No
• Will tree(s) be removed in association with proposed proiect? DYes(must submit separate Tree Removal Permit) IZINo
Describe in detail the type of work to be performed:
Replacing existing fence as shown on attached sketch
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name Carson Roberts Address 411 Skate Rd
City Atlantic Beach State FL Zip 32233 Phone 904-535-3615
E-Mail crobertm@gmail.com
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Big Jerry's Fencing Qualifying Agent Jon Davis
Address 12620 Beach Blvd,Ste 3-131 City Jacksonville State FL Zip 32246
Office Phone 904-476-2528 Job Site Contact Number 904-476-2528
State Certification/Registration# N/A E-Mail Jon@BigJerrysFencing.com
Architect Name&Phone# `
Engineer's Name& Phone#
Workers Compensation Insurer OR Exempt II Expiration Date 2/13/22
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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDIN O NOTI_C�E OMMENCEMENT.
(Signature of Owner or Agent) `�---- (Signature of Contractor)
Signed and sworn to(or affirme.)before me this c2 ) day of Signed and sworn to(or affirmed) before me thisL-3 day of
T ei , r ) (L, by `� .1� a, C a J` , E> , bye ,ay. I Lits
T
• r- -f • - (Si r ' . Notary)
ro.#"% Notary Public State of Florida JOHN P LUNNEY
Melissa N Rectenwald
�c My Commission GG 111814 ] ersonally Known OR COMMISSION#GG050934
[ ]Personally Known OR ✓�
,, of Expires 06/05/2021 ';FoF J ' EXPIRES November 29,2020
[�Produced Identification Produced Identification
Type of Identification: Type of Identification: F'-
Description of Fence: Customer Info: RY'SFt C,
6' tall board on board pressure treated pine RED Carson Roberts ��G�ER N ��
I
6' tall board on board framed in between 6x6 with post caps, a 2x6 top trim and 3 deco runner boards 411 Skate Rd ,,J
4' tall board on board framed in between 6x6 with post caps, a 2x6 top trim and 2 deco runner boards Atlantic Beach, FL'333
' 1 Ofl•E 92.79 FlELA , I $ I z h�,. ,.,w•"'•�
• <: (H82'3 M 9 �/T' w�oK , au 91gJ rnFonda nm
3a '
' '1'. \ 82,'4 3.5S n ...- a d
k
:'
1 , :'!"14:1..ili: PPM
•
is 1
it i r I
i"4 .4
•1 N r^
.'e
wood 1 ► a
' I • ZO STEPS k. COyEREO ` 1 Ili.311Ini
i ►,,i4 PaRCH 'a,
LOT
a 1—STORY BRICK 1, �► W
.— z5 0' 411 i 1
g rn NUMBER • x I ,t N,,
1 t • 6
N ;�1 `1 I.
g
a + ' r •
t1 I I t Il � �
7p3-
Z _J Q\ C
r d q P AO 1 1 1
r� ii•g 7,5.0' K I 1 ' 1
G) - CONCRETE I 1 1I ie Ut r,aivFWAY ts 1 ..7'
• 8'Wide Double Gate I 1 I ,r
Il
7.7' pitlVACY
A, • r X 1 1 .
e wood _._,_. ..�-- ,r
x '� 93.{x, "° 11�' 1
:•:.r. 682.43'58' , ! 1 1
of 0� +l'E •93.07' FlE D ) 1 1 (Note: Sketch is not to Scale
"-iy`r, REVOCABLE ENCROACHMENT AGREEMENT
';` 4` ''�t�.1 City of Atlantic Beach **ALL INFORMATION
1� /I 800 Seminole Road,Atlantic Beach,FL 32233 HIGHLIGHTED IN GRAY
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
C(.J (\ CD 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.
VI (-C.
This work is generally described as R , rep! a c-•e„►�n
( .e-i/l .
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 noti t USER shall be given by certified mail, return
receipt requested,to the following address 1 \ S Ati a h.ti c fr k Pt -322,33
• 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 ties are hereby assumed by the USER.
C Date l b'2 -2 / 2-6
Property Owner/Agent(signed in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL `]
The fo going instrument was knowledged this ( day of (4 , 20 2Q
by r � I �i�J�� ��� PersonallSd who appeared before me and
Y pp
. inted name of Signer)
ack • edged t aro •o signet)the instrument v.luntaril for the purpose expressed in it.
...0:;%,,, TONI GINDLESPERGER
Cf._ .
_ 1%, :,: #GG 353178 Department Approval:
MYCOMMISSION
a.� • -
"v• N off; EXPIRES:October 6,2023
' O
'FF FLOP:
Signature of Notary Public,State of Flori B°ndedThruNotary Public Underx,iters
[ ] Personally Known
[ ] Produced Identification (Type) �� Scott Williams, Public Works Director
H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
i RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION **ALL INFORMATION
City of Atlantic Beach HIGHLIGHTED IN GRAY IS
. 800 Seminole Road,Atlantic Beach, FL 32233 REQUIRED.
Ll
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND
OBTAINING UTILITY LOCATES
' Ali
Job Address `�I d ` c .I L a v ► C 001 PI-Permit Number
Contractor Information ' ' 'n �
Company t S £ f<..4 C''1 f r�1
9 Qualifying Agent
Address City n State y Zip
•
Phone �0 -Iu 297 co 2,S 2—g Email1 J OY1 k1Su -'C.rr Jsf-evict vO' 'CV/ ' l
State Certification/Registration#
Architect Phone Email
Engineer Phone Email
Workers Compensation Insurer OR Exempt o Expiration 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
��
supervision of V1lQ/1 Q �� (Project Superintendent)
with (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.
• e Wor s Director shal e notified 24 hours prior to starting work and again immediately upon completion.
a Date
Permittee ign:d in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was nowledged this Z--'7 day of CD 4 ,20
by
TIFC)
rL• P(`-E ,who personally appeared before me and
(printed name of Permittee)
acknowl- t he/sh si;n : the instrument voluntarily for the purpoex e n
!a•u , t1 ONI GINDLESPERGER
ck‘ :T MY COMMISSION#GG 353178
P EXPIRES:October 6,2023
0- _ - I 1F-.061±g°onApP4e Th 4otary Public Under
Signature o Notary Public,State of F • •: I J Produced Identification (Type]
H:\Applications&Forms\Word&Excel Document Originals\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18