482 SAILFISH DR E RFNC21-0061 =r.-. . Building Permit Application Updated 10/9/18
v - 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 REQUIRE
Job Address: Lkcis i SA-I L F ISA- Permit Number: R NCZ( — yyD.
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Legal Description Oi-1b /7Z5-iyc./7,e/PaePro 6 .JYAC taikA-/SCIA/1rZA RE# (7I -k)3- 0006
L) I i? 3LKi4.
Valuation of Work(Replacement Cost)$ c-clru Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ,few ❑Addition ❑Alteration ❑Repair ❑Move ODemc4itcy ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ZNo
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) all°
Describe in detail the type of work to be performed: (."rr91Jj/= )0.5; r- i&.&3 'et,'^ G' ' '.�^, C-r-�
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Florida
—Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name ..)(h= Stitt/� Address 6/232319'/1-45d
City Ai-it 4^'T r! G� State F.— Zip 32 Z 3, Phone 9ez/ 6/,, 3 i 7e;
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information r
Name of Company 1 iI 5' TGL.7! -57— �,4'� Qualifying Agent Vi.)t/.aT-,14 q- ''e'z LA 5 L 7--"-
Address /2Zl6--444 PAG-e.5 "W S City 414 _ &e:///4 State PC-- Zip _CZ Z3...
Office Phone goy 7Og7 4:-5 Job Site Contact Number
State Certification/Registration# E-Mail C r!>G Pc."-)C��Cr,"A/L . C
Architect Name&Phone#
Engineer's Name&Phone# `
Workers Compensation Insurer OR Exempt Expiration Date 7/1i/Z)l-/
Application is herebymade to obtain apermit to do the work and installations as indicated. I certifythat no work or installation has
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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 FI i CING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDI4 Yl, • 10T1 - OF COMMENCEMENT. • -----
1 l (Si nat of Owner orAgent) (Signature ontractor)
JDsD,p�! T1 I (6iAl �S d`IL, Jc)Al d,—f/..o N ` fza iJr 57-
Sig ed and sworn to(or affirmed)before me this,-, day of Si ned and sworn to(or affirmed)before me thiso -day of
IL. , c2bc1 S0'5GP Z v21..? IL , .. (.3Z/ 30*-1RT.I )- QC%LCut -1"
. - • '• a
off/kyr Notary Public State of Florida • ,..00 ,,F Notary Public State of Florida •.
Roberta 0 Carlisle , Roberta D Carlisle
My Commission GG 251658 • My Commission GG 251658
personally Known •It�iy�^ Expires 09/1 512 02 2 ['1 Personally Known OR a^ Expires 091/5/2022
[ ]Produced Identifie, .-r [ ]Produced Identification
Type of Identification: Type of Identification:
.. LA.'r, Fence Addendum Updated1/14/2021
*As-Welk City of Atlantic Beach Building Department
W �
�� 800 Seminole Road, Atlantic Beach, FL 32233 PERMIT#
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
42-cifLfr5
Property Type: Lot Type/ Features:
Residential JY-One Street frontage(interior lot)
❑ Commercial ❑ More than one street frontage(corner lot,through lot,
etc.)
,Swimming Pool
Fence Material: Fence Height (select all that apply):
❑ Wood 0-Four Foot(4ft)
❑ Chain Link Six Foot(6ft)
Vinyl ❑ Other
❑ Block/Stone (Plan details required for footings and/or
retaining walls)
❑ Other
Fence Location:
Please submit an accurate and current boundary survey showing all existing improvements(including building footprint,
driveway, swimming pool, etc.) and location of fence/wall and any gates. Plan details required for block wall footings and/or
retaining walls and any portion or fencing above 6ft in height.
Will the fence be built in an easement?
❑ Yes (must submit separate Revocable Encroachment Agreement)
�N o
Will tree(s) be removed in association with proposed project?
❑ Yes (must submit separate Tree Removal/lNo
Conditions of Approval:
• Roll off container company must be on City approved list. Roll off container cannot be placed on City right-of-way.
• All old fencing and debris must be removed from job site by contractor or homeowner.
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.
ORDERED BY: ,', •.--— t '.:1 ' + s' t
The Law Offices of Rod Schloth ; �, ,I.-%'-' ' ✓ s ti
2187SThirdSt ! •' -'
1 t i 1 _ sr �. .a
Jacksonville Bch, FL 32250 _./; (,(1. =_ I. r 't��.:. '
904-372-9351 17 i /,
beach@rod-law.com .__ ._..•__
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PROPERTY ADDRESS:482 SAILFISH DRfVE ATIALANTIC BEACH,FLORIDA 32233 SURVEY NUMBER FL1307.1110
FIELD WORK DATE:in 2/2013 REVISION DATE(S):IREvo nimoil)
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BOUNDARY SURVEY
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11 p�✓ I hereby.- •:Mks .go of•r-:, .f the hereon
desoixd..rty has .e . dire r,
and to the. iii andbef•-f, isabue
and..• E-,T.' meets the
minimum . s. se{ by Florida
�1 Boarder . Lsroa' eyasgB`:Bodee. in
30 20 i0 0 15' 30 ChaplelSJ-17 7• 71dIn1. •'• -COde.
�� GRAPHIC SCALE WRebuked aasW
,I,..+, I RAP=30 foot greed Pourer PtobmmrSa+epar.O*ace'
lkenr Na 3758
the e(This Surerb•Pupaes of etha, eN women 9erk000n..J be at Use Users Sole Risk and w0Aaut Uab&ry to the s.ereeo•.
Nothing hereon O. .o Goo Ate Rghts of Benno to Anyone Other than those Certified
FLOOD INFORMATION: POINTS OF INTEREST
BY PERFORMING A SEARCH WITH THE LOCAL GO:. (1)6'WOOD FENCE OVER S'EASEMENT.(2)POOL&PAVERS OVER 5'
MUNICIPALITY OR WWW.FEMA.GOV,THE PROPERT` RS TO BE EASEMENT.
LOCATED IN ZONE X THIS PROPERTY WAS FOUND itr ..c CITY OF
ATLANTIC BEACH,COMMUNITY NUMBER 120075,DATED 06/03/13.
%*IL...,'7,; Florida Land
CLIENT NUMBER:RS13-1637 DATE:7/13/2013 AFFILIATE
�` lILIeTAssociation: MEMBERS
BUYER STEPHANIE.1 BURNS 'FLTA
SELLER STEPHEN LANHAM&SCOTT R LANHAM
CERTIFIED TO:STEPHANIE J BURNS;THE LAW OFFICES OF ROD I.- C �j,NA=
SSURNCE COMPANY;EVERLOTH,PA;OLD BANKONAL TITLE uuu �I
Land Surveyors Inc. �.
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4 1 '"� REVOCABLE ENCROACHMENT AGREEMENT
',, i ' City of Atlantic Beach **ALL INFORMATION
A800 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
009.51- 'IV cvl F5NGL- de?' 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 1E^3 - Re.it iOG ✓s"a;} .
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 #2'Z -Colla Fc S H --7e , .
• 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 Ian.. USER further agrees that the CITY and its officers and employees shall be
saved harmless by the USER -•m any of the work herein under the terms of this permit and that all of said
liabilities are hereby ass • ed • the USER.
__...........� Date_�, 2/0/
�
Property Owner,Agent •:ned in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this �. day of , 20 Z ,
b —.0 A14,4tt J" ' O-zQ 0, ,e-,— ,who persona y appeared before me and
11
;ranted nam- •fSign-r)
ackn. ledged tha .h: s gned the instrument voluntarily for the purpose expressed in it.
0 Ill Department Approval:
` i►P:"yet;•. TONI GINDLESPERGER
Sign re of Notary Public, Stat- • Florida :' -,.;'°`_ MY COMMISSION#GG 353178
Personall Known '+' "°'
Y r.��-�PW•; EXPIRES:October 6,2023
[ ] Produced Identification(Type) `FP,F.F`°' Bonded ThruNotary Public Undeneers Scott Williams, Public Works Director
H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18