415 Irex Rd Fence Submittal (f- 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
��trtt!fr IS REQUIRED.
Phone: (904) 247-5826pEmail: Building-Dept@coab.us
Job Address: N�1 I e /' 9 Permit Number:
Legal Description 31 -I(o 17-2S -7 96— /` j° O�fOred, f?3i,v17$U'' r?I3 RE# 17114 I S — 0CAdo
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Valuation of Work(Replacement Cost) $ C/70 1 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ECommercial , f esidential
• 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: t,)C7-0 r)t ti Lir
Florida Product Approval# for multiple products use product approval form
Property Owner Information ,{ _
Name GC P L- )/' 1 Address C/i5 /�ZC„' f)
City /g-`� G g`AL N' State Zip Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company( T To Co(t5_ �%�.Y�� ec) Qualifying gent JU',, '7�'L-�✓� S
Address /ZZ I P f&- l 14= S City � State 7L Zip 32 Z -
7Job Site Contact Number
Office Phone �� !1 fj � ? 5 � f,
State Certification/Registration# E-Mail CTO 'I -'- C` �"��7 Lam`—►
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt/Expiration Date
7 tr t2-
3
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
RECORDIIM YOUR NOTICE OF COMMENCEMENT.
C t (S' nature of Owner or Agent) JO” 4.440i ontractor)
Si ned and sworn to(or affirmd)beforerne his-day of Signed and sworn to(or affirmed)before me this f q day of
` l , __ , AGo dj`T ml1'I , 2191,by
(Signature of Notary) (Signature of Notary)
:�^Y' SUSAN E.SOLOMON •" t
I: . ~" ms•., CHRISTIAN GILES i
;+ MY COMMISSION#GG 283750 personal) Known OR
[ sonally Known OR ':,; ,., ] y A MY COMMISSION#HH 117153
;���ra' EXPIRES:December 12,2022
[ )Produced Identification F•...•aP; IdentificationBonded Tlxu Nary Pubric Underwri!ers rptType of Identification: 1oduced
ype of Identification:lL // °F,°`, BondedThruNutaryPublicUr a titer. ,I
MAP SHORING A SURVEY OF,.
LOT 24 BLOCK 10, REPLAT OF PART OF ROYAL PALMS UNIT TWO A AS RECORDED IN PLAT
BOOK 31, PAGES 16, 16A, 16B, 16C AND 16D OF THE CURRENT PUBLIC RECORDS OF DUVAL
COUNTY, FLORIDA.
PI
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TRITON ROAD
AD
NOTES:
1)THIS IS A BOUNDARY SURVEY.
2)BEARINGS BASED ON EAST LINE OF IREX
ROAD AS N 716'02" W. 2973 SQUARE FEET OF IMPERVIOUS.
3)25' BUILDING RESTRICTION LINE PER PLAT.
4)ALL FENCES 4' CHAIN LINK UNLESS
SHOWN OTHER.
THE PROPERTY SHOWN HEREON APPEARS THIS SURVEY WAS MADE FOR THE BENEFIT OF
TO LIE IN FLOOD ZONE "X" AS WELL AS CLYDE BLUNK.
CAN BE DETERMINED FROM THE FLOOD
INSURANCE RATE MAP COMMUNITY PANEL
NUMBER 120075 0001 D, REVISED APRIL 17,
1989 FOR THE CITY OF ATLANTIC BEACH,
DUVAL COUNTY. FLORIDA. LD____\.._ ....._ • ,
DONN W. BOATWRIGHT, P.S.M.
"NOT VALID WITHOUT THE SIGNATURE AND THE FLA. LIC. SURVEYOR AND MAPPER No. LS 3295
ORIGINAL RAISED SEAL OF A FLORIDA LICENSED
SURVEYOR AND MAPPER." FLA. LIC. SURVEYING & MAPPING BUSINESS No. LB 3672
CHECKED BY: BOATWRIGHT LAND SURVEYORS, INC. DATE: FEBRUARY 2, 2009
DRAWN BY: $WC 1500 ROBERTS DRIVE SHEET�OF 1
FILE #: 2009-0055 JACKSONVILLE BEACH, FLORIDA 241-8550
• `�; REVOCABLE ENCROACHMENT AGREEMENT
**ALL INFORMATION
t` _ + City of Atlantic Beach HIGHLIGHTED IN GRAY
Mir 1
800 Seminole Road,Atlantic Beach, FL 32233
IS REQUIRED.
r
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
Cory5T 17j('Lira T Fa-, GZ. Cr? 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 Fe- , ) TAC.CA T` 0 '''S
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 05— /a7-CX .
• 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
liabilities are hereby assu r-• .y the USER.
'_ Date c f9' 2/
Property Owner/Agent(signed in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this 11J day of ni A y , 20 2_l ,
by JO^-1-47114.--) ...:1-41-4,Li , ,who personally appeared before me and
(printed name of Signer)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
ei.1 r/" '�` � 9 :�^� CHRISTIAN GILES Department Approval:
'. • ' MY COMMISSION#HH 117153
Signature of otary Public, State of Florida ,.? .
[ ] Personally Known _ %''•+�_�'�' EXPIRIiS:April 13,2025
yy�� • r �:' BcnAed T1ru Ndery PuDYe
{/Produced Identification(Type) '" L- yL -f"� -,Williams, Public Works Director
H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
A '1/2. Fence Addendum Updated 1/14/2021
City of Atlantic Beach Building Department
��+ 800 Seminole Road, Atlantic Beach, FL 32233 E 9 PERMIT#
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
41 S 1f/i ///Z i
Property Type: Lot Type/ Features:
residential 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 ❑ Four Foot(4ft)
❑ Chain Link Six Foot (6ft)
Vinyl ❑ Other
❑ Block/Stone (Plan details required for footings and/or
retaining walls)
O 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)
❑ No
Will tree(s) be removed in association with proposed project?
❑ Yes (must submit separate Tree Removal Permit)
la'No
/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.