251 S NAUTICAL BLVD FNCE20-0145 ''r'' Building Permit Application Updated 10/9/18
Vi . , City of Atlantic Beach Building Department **ALL INFORMATION
, ; 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
''' IS
REQUIRED.
Phone: (904) 247-5826 Email: (Building-Dept@coab.us
Job Address: 25 I PJc 1 Blvd Atl�1 11 1 32233 Permit Number: I--- i\)CE 2O —C�i 15
Legal Description 0100 S:ri,fix. Iown:iy RE# )70 703 037 G
Valuation of Work(Replacement Cost)$ SOLI 9 .51 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration Xi3epair ❑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: , e
R''tc titt cXt�Ftny Wood - saint, SaW!41 � _ w, __
Florida Product Approval# for multiple products use product approval form
Property OwnerInformation
.Information r
Name Co"5.- J nS "..5 Address a ;auk a I lid
City AMA»t;` I�cac 1. State FI Zip 32233 Phon- • • > 6,..S
E-Mail j 4tr G r�mc i . Yrat `.
Owner or Agent(fl Agent, Power of Attorney or Agency Letter Required)
Contractor Information p
Name of Company Spovl w Fe.,,,..., 0,..,/ g.11 Qualifying Agent 1jvud f^,, t.v
Address Sill I-1; I,i y Avt- City 3crc,(,sr,„v,'Pt- State F1 Zip 322_514Office Phone 504 r;g3 (,3M9 Job Site Contactn� Number
State Certification/Registration# 16s R.S°I E-Mail_ R1 4J• p
• l O _reAc y jaricrmv!)6 o coin
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer F cip„..f,ea-I AA-I-up,' OR Exempt 0 Expiration Date q/ ISP-C/2—1,
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 OUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO 0: Al FIN , , I► , CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
REC• •DI c Y," : OTICE OF COMMENCEMENT.
(Signa re of Owner or Agent) ignature of Contractor)
Si ned and swornrto(or affirmed)_` beforegme t is..g day of Signed and sworn to(or affirme.)befpr ne this 2 r day of
�,OA-0, by e..0r)e-6 � tliieeAc. �r s Dur�►�1 b�', w� Y C yi d r•-1.--.
(Signature of Notary) (Signature of Notary)
[ ]Personally Known OR ip`•'`i,. '•.JANMAURICIO WALKER ROBERTSON personally Known OR �'� Mani u njp�e of Fonda
,tN MY COMMISSION#HH 009325
,[�]'1'roduced Identification =* *= i Produced Identification :t� aty Commission HH 011346
1.,•7;e::'°'-if-
,,,,,„,,,
r.n:,o`; EXPIRES:June 11,2024 a of Identification: a Expires 08!16/2024
Type of Identification: r:.. , � ..._ yP
MAP SHOWING BOUNDARY SURVEY OF
LOT 5 BLOCK 4 ACCORDING TO THE PLAT OF
SEASP ; Y
AS RECORDED IN PLAT BOOK 35 , PAGE(S) 64 AND 64A OF THE CURRENT
PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO: CONRAD JURGENS, PAT JURGENS,
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
AND GIBRALTAR TITLE SERVICES.
NAUTICAL BOULEVARD SOUTH
(60' R/W)
N 22°32'00" E 75.00' (R'
N 22'3200" E 75.30' (M)
BEARING REFERENCE LINE FIRE
HYDRANT
all "Ilr'
1/2" 1/2"
_ 335.00' (R)
• •
1/2^ 334.50 (M
•. CONC. LAIIJ
°. V
i ?P
N •. < N W
°
a 20' B.R.L.
1
7.8' 15.2' o w'� +0 25.9' 8.8'
IQW
N 17.5' N KC0V0
AREA 13-4-0.4' l0
-v I STORY STUCCO m -�O ,41
O 0 4� RESIDENCE •
N d
O ❑ W/ 1.5' EAVES h
U ' ori o NO. 251 A/C ❑ co Q Y
0v'sa, PAD ~ O W
CD ❑ 24.4' ... m
: 8.6 ❑ �w h
O c CONC. . 0 C.Z.
1--,) ^ ❑ 7.8' 34.3' _° n,� F
O cO co 0� O
2 cn
❑I to
LOT 5
❑ BLOCK 4 ❑ 20
i
. 1/2"
❑ IRON ROD
CC-
'----
0.45' NORTH
10' DRAINAGE, UTIU11ES & SEWERS EASEMENT 0.42' WEST . t; Al
0.3'--
.--0.2'
0_2� 114 r-0,3' f BOUNDARY LINE D.1'
❑ 0 (,4...__/p
X•I / X X ❑ X 1:1 , --1:1 X ❑ X X -lax-lax- II�� l
�'+ 4' Yv
1/2" 0.7' 1/2" � � /�y
LOT 450 BTN I LOT 449 I LOT 448 i (�S 22'27 33" W 74.77' (M)
IS 22°32'00'' W 75.00' (R)1 tli)
SECTION NO. 1 SALTAIR
P.B.10, PG. 8 19 ' '7
FLOOD ZONE "X" = AREAS DETERMINED TO BE OUTSIDE THE 0.2%ANNUAL CHANCE FLOODPLAIN /FLOOD ZONE "X (SHADED)" = AREAS OF 0.2%ANNUAL CHANCE FLOOD; AREAS OF 1%
ANNUAL CHANCE WITH AVERAGE DEPTHS OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN 1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM 1%ANNUAL CHANCE FLOOD.
~�Y� I GENERAL OTE3:
+'->>ir REVOCABLE ENCROACHMENT AGREEMENT
5-• �=' **ALL INFORMATION
• ` \I City of Atlantic Beach
11 800 Seminole Road,Atlantic Beach,FL 32233 HIGHLIGHTED IN GRAY
}�T. J) IS REQUIRED.
REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and
exis n under th aw�f t State of Florida, hereinafter referred to as "CITY" and
' 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
FBeach.
This work is generally described as J,,/ •� ( 1_ (fes
Any facility maintained, repaired, ere d, and/or installed in the exercise of the privilege granted remains subject to
relocation or removal on thirty(30)d 'notice by CITY toq�ER,sai netic o 1,S /RR ss9I be en by certi ' ail, return
receipt requested,to the following address o�5 I W a dY"'' ` 1'3
.
• 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
spe ' ' : ions, to include utilities locate requirements and use limitations/requirements of easements, public
,ght-of- ays and o • :r public land. USER further agrees that the CITY and its officers and employees shall be
saved ha less b' r• USER from any of the work herein under the terms of this permit and that all of said
liabilitie a • h . assumed by the USE:
IIII Date ' 2/ g/ 12
Property Owner/Agent(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL 7
The foregoing instrument was acknowledged this day of ,
? Q , 202
bytr C) f rG �U r e �S ,who personally appeared before me and
nted name of Signer)
ack . �ledged that e/ h i ned the instrument voluntarily for the purpose expressed in it.
et_ Department Approval:
Ott`P4�
Signature of Notary Public,State f Flo Aida =::• i.%. TONI GINDLESPERGER
,; , MY COMMISSION#GG 353178
[ 1 Personally Known :s. b;' EXPIRES:October 6,2023
s'°F,F,1g.• Scott Williams, Public Works Director
[ ] Produced Identification (Type) EiondedThruNotaryPublicUnderwriters
H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18