1668 Sea Oats Dr DWAY20-0048 PermitOWNER:ADDRESS:CITY:STATE:ZIP:
CROWDER THOMAS E 1668 SEA OATS DR ATLANTIC BEACH FL 32233-5836
COMPANY:ADDRESS:CITY:STATE:ZIP:
Montebello Construction
LLC 5518 118th St #136 Jacksonville FL 32244
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
172020 0224 SELVA MARINA UNIT 06
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1668 SEA OATS DR DRIVEWAY SINGLE OR TWO
FAMILY DRIVEWAY
replace concrete driveway &
sidewalk $11300.00
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 DRIVEWAY APRON INFORMATIONAL
Notes:
All concrete driveway aprons must be 5 inches thick, 4000 psi, with fibermesh from edge of pavement to the property line. Reinforcing rods or mesh are
not allowed in the City right-of-way.
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.
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.
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.
1 of 2Issued Date: 12/2/2020
PERMIT NUMBER
DWAY20-0048
ISSUED: 12/2/2020
EXPIRES: 5/31/2021
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
WORK WITHOUT PERMIT 455-0000-322-1000 0 $110.00
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00
TOTAL: $235.00
2 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL
Notes:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line (904-247-
5814) to request an Erosion and Sediment Control Inspection prior to start of construction.
3 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
4 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL
Notes:
Roll off container company must be on City approved list. Approved list can be obtained at the Building Department at City Hall. Roll off container
cannot be placed on City right-of-way.
5 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
6 PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
7 PUBLIC WORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking and debris must be removed from job site by Contractor.
8 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
9 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL
Notes:
This permit is Approved to remove and replace as is only. A Revision must be submitted if any additional work is wanting to be done on this project.
2 of 2Issued Date: 12/2/2020
PERMIT NUMBER
DWAY20-0048
ISSUED: 12/2/2020
EXPIRES: 5/31/2021
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Building Permit Application Updated 10/9/18
J/
City of Atlantic Beach Building Department ALL INFORMATION
1 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
us+ IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: f L8 f Olis L7' Ar.4,4J;/c Permit Number:
Legal Description 3e 2ba i+Qv'M ,c.7 /0 j2J)(k /3 D/4/17" 4 RE#
Valuation of Work(Replacement Cost)$ /1,303 Heated/Cooled SF d c£6o'VE
Class of Work: New Addition Alteration Repair Move Demo Pool WNRllgw/2oyr
Use of existing/proposed structure(s): Commercial Residential
r JJ
If an existing structure,is a fire sprinkler system installed?: Yes PINo BY:
Will tree(s)be removed in association with proposed project? Yes(must submit separate Tree Removal Permit). girNo
Describe in detail the type of work to be performed: R6:410,'4i 4vp f 6.0Ai 4- -
Florida Product Approval#for multiple products use product approval form
Property Owner Information
Name -74o4/4-S L., C,DuJDCips Address 44,ff .f'q 0•4rS vk'
City 4 iZ J7c f `4f-/( State ,C Zip 1.4233 Phone Lt . .Ci]-$94 4S-
E-Mail sE-Mail l.r'..Clt ,rl _;_iwwd a (,,,1
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) 4 /, -
Contractor Information
Name of Company 10,://2-;g«ice;) c„,,/s-r,,4L.C- Qualifying Agent M€A,/TW k VU
Address 3-5-is" / s Sr '/3(o Citycl ift;g State pi Zip 322 '
Office Phone gelif-i- 3 Job Site Contact Number
State Certification/Registration# E-Mail W Mil MbA)1lMi36- -' c.cealrRu to/J. c.;.n
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 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
RECORDING Y OF COMMENCEMENT. j
Signature of Owner or Agent)ignature of Contractor)
Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)before me this ay of
VO ieJ ,,G ,by C1 tiGs r. 61-o'-4-- Nd1/1:.1''Yl 2oLV ,by L Li 0 h. MVit ck pro
AAC^t-n t 7'-W r
namtlr
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JANMAURICIO WbLKER ROBERTSON
MAREN QUENBY EVANS
MY COMMISSION HH 009325 Notary Public•State of Honda
o, EXPIRES:June 11,2024 Personally Known OR r d Commtss on;GG 338733
P rsonally Known OR ";
eo F,,,, Bonded ThruNotary PublicUnden+rtters My Comm.Expires May 27.2023ProducedIdentificationProducedIdentification
Type of Identification: r
Type of Identification: tALYjtN 4S iA3r e -- - ---- -
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PLOT PLAN
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LOT . I BLOC , J3, UNI.T Co
PLAT BOOK 34- , PA(. 7(S) SIA
CURRENT RECORDS, i,UVAL COUNTY, FLORIDA
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APPROVED
10.91 14 rAe Coni.I •mm ee
SEA TS DRIVE
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DATE MA 4 19 ... .........
1 1 Ce G. i. -a Or vim 3
e .'et. RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION ALL INFORMATION
G City of Atlantic Beach HIGHLIGHTED IN GRAY IS
r
800 Seminole Road,Atlantic Beach, FL 32233 REQUIRED.
J1 t.
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address /(' SO4 a-r l Al Arthriret. 3654yeA, FL Permit Number
Contractor Information
Company ;ON f6-D c'Lw ( Si 1 ?c U-S 4(C. Qualifying Agent LLLCib G mats7-g4--Vo
Address Ss-/S" /[s, S7 2r/34, City .71444-414.4/7/.../...&--- State FL. Zip 32 Z 49-
Phone980zip fgcj 9.00,i3v).37 Email/if eeu9&-.7-4 _. r0 „rl2UQ YI4Nc_r/o, l 0(44.•,1
State Certification/Registration# G lgcwoo.,31.
Architect Phone Email
Engineer . Phone Email
Workers Compensation Insurer rat ;lI j _ :l A. .•. •., 4 .: ..n _ r: r• ' Exempt o Expiration Date Vg2q x
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 L_UGro 6-r /to,4-rei/o Project Superintendent)
with(Company Name) 4W, I7 7B e21,6 e.,: o.X 1Ru _77 a N Phone c183---- A.1 ci4
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
exp- ses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges.
h• s blic W.dg P irk. shall be notified 24 hours prior to starting work and again immediately upon completion.
Date 1 11 a 31 azY1O
Pe' tee(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this ' •3 day of (:)k)Lin bine- 20 a-(, ,
by TN OIY -C(S (_i D vt) X (who personall appeared before me and
printed name of Permittee) JENNIFER JOIINSTON I
acknowledged tha e/she signed the instrument voluntarily for the purpose expressed in it. ...a. IAY COIAIIISSION 1 HH 067070
I;;;,..,r wEXPIRE&October 27,2024 1 1
pii
Bonded lhv Nofa y Pitfe Utd,uu s 1
Personally Known
Signature of N a ic,State of Florida U4Sroduced Identification(Type) 1r L .0 L 1
H:\Applications&Forms\Word&Excel Document Originals\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18
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