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395 12th St FNCE19-0104 Submittal 4��,y� City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) '2 800 Seminole Road -1=-1.10c- `� /L s Atlantic Beach, Florida 32233-5445 _v II U 'C ci Phone(904)247-5826 - Fax(904)247-5845 �, ;t �;• E-mail: building-dept@coab.us Date routed: (.-E t City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3 Z .� { Department review required Yew No uildin 1/ Applicant: (.,___ O (D 3 i en/ i G2OJP Planning &Zoning ( Tree Adrmirii or Project: I1�C_ cPublic Works is Utilities - Public a ety " Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: <proved. ❑Denied. Not applicable (Circle one.) Comments: BUILDI i PLANNING &ZONING1 Reviewed by: yrir Date: P-/05"/, TREE ADMIN. Second Review: Approved as revised. ❑Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ['Denied. ['Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 rsy�ly City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) r 800 Seminole Road • �wc C I (� ,�`, 0 /) �� Atlantic Beach, Florida 32233-5445 lJ`1 V Phone(904)247-5826 • Fax(904)247-5845 on !e E-mail: building-dept@coab.us Date routed: ft9S City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3q, ' I D9,parlent review required Yes No Applicant: (111 OVCI�A�i e.c)(07-Q__voof;:f(Littilicling-}1nning &ZoninT") (�- tree Admi� nisfr ror Project: ( ( 1 c-& . is Works is Utilities Public a e y Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. nDenied. nNot applicable (Circle one.) Comments: BUILDING PLANNING &ZONING • Reviewed byt.fig_Date: oPir/y TREE ADMIN. Second Review: ❑Approved as revised. ElDenied. ['Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ['Denied. nNot applicable Comments: Reviewed by: Date: Revised 05/19/2017 .11.41.1j. City of Atlantic Beach APPLICATION NUMBER r } � 116 Building Department (To be assigned by the Building Department) ~ ri 800 Seminole Road JJ /, 4 �.� Atlantic Beach, Florida 32233-5445 k) I "U i U Phone(904)247-5826 Fax(904)247-5845eth ,0;1 qr E-mail: building-dept@coab.us Date routed: t-B l City web-site: http.//www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: • 3'L De art ent review required • Yes No uildin Applicant: i\_)F\ i eC)107-�200f) P nning &Zoning (�- Tree Administrator Project: ublic Works is Utilities Public a e y Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept.of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ❑Approved. Denied. of applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: glq-(9 TREE ADMIN. Second Review: ['Approved as revi ed. ['Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 City of Atlantic Beach APPLICATION NUMBER :,s Building Department (To be assigned by the Building Department.) II tJ 800 Seminole Road (� 0 � Atlantic Beach, Flori �_'da 32233-5445 I I1CC I —I "0 4- Phone(904)247-5826 • Fax(904)247-5845 �o;s11 , E-mail: building-dept@coab.us Date routed: l-S t City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3C, c lI Z De ent review required Yes No uildin Applicant: LOV CC�I��Sc`11,Qp0f' P nning &Zoning Tree Adminis r or Project: Cl ( r .-)C ublic Works is Utilities Public a e y Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: pproved. ❑Denied. I INot applicable (Circle one.) Comments: BUILDING f� PLANNING &ZONING Reviewed by:�� Date: V l - 19 TREE ADMIN. Second Review: Approved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 Building Permit Application III " Updated 10/9/18 "ALL INFORMATION HIGHLIGHTED IN GRAY City of Atlantic Beach Building Department IS REQUIRED. 800 Seminole Road, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: 395 12th Street Permit Number: I lV C 19 -D I °I— Legal Description 03127 Selva Marina Unit 01 RE# 171922-0000 Valuation of Work(Replacement Cost)$3,000 Heated/Cooled SF Non- Heated/Cooled • Class of Work: DNew X Addition ❑Alteration ❑Repair X Move ❑Demo DPool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial X Residential • If an existing structure, is a fire sprinkler system installed?: DYes X No • Will tree(s)be removed in association with proposed project?DYes (must submit separate Tree Removal Permit) X No Describe in detail the type of work to be performed: Existing fence along southside of house to be moved to corner of house at building restriction line. Existing fence along north side of house will be extended to east building restriction line to house corner. A new section of fence with access gates to rear of property will be added along east side to match the existing fence on the south side of the house. Florida Product Approval# _ for multiple products use product approval form Property Owner Information Name Walter Thomas and Janna McNicholas Address 395 2th Street City Atlantic Beach State: Florida Zip: 32233 Phone: 912-506-1044 E-Mail: janna@fcvets.com Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Ellen G.Wheeler Contractor Information Name of Company Covenant Construction Group Qualifying Agent Angela Claxton Address_204 Blairmore Blvd Ea. City:_Orange Park State: Florida Zip 32073 Office Phone 904-372-1156 Job Site Contact Number_904-347-7027 State Certification/Registration #CBC060019 E-mail idugger@topscapes.com Architect Name& Phone# Ellen G.Wheeler 904-610-5798 Engineer's Name&Phone# N/A Workers Compensation Insurer The Hartford _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 RECQ DING YOURANOTICE �F COMMENCEMENT. 6 , (Signature of Owner or Agent) Ft Signed and sworn to(or affirmed)before me this i day of l'2I1 ,by cc tc <M.! ,Signa Pre"of Notary) FRANK M.BRENNAN •?o.• `•!�;; �a MY COMMISSION MGG 287368 EXPIRES:April 28,2023. Bon 'rF UF1Fl0�' ded Thru Notary Public Underwriters [ ]Personally Known OR 1111. 0l (Produced Identification Type Identification: G Pr:LA, ISlgnature of Contractor) Signed and sworn to(or affirmed) before me this‘2. day of 00403.►S't , 20V31 ,by Qo(Aa C4\,A (Signature of Notary) pmt 44, Notary PUCIIG Std:at Florda Robin Jo Colina Personally Known OR My Commiss+on GG 202613 [ I Produced Identification 0.0e<Gresov17rzoza Type of Identification: To Whom It May Concern: I,Janna McNicholas, authorized Ellen G.Wheeler, RLA to act as my agent in regarding the fence Atlantic Beach, FL relocation/building permit for my residence at 395 12th Street,Atlantic Beach, FL PI N e Date SOUTHERLY 30.00' '" r o � O W1 NI l* ZO C7 I O: LOOM.a EUSiNG FENS— /V�. ' 'FiH HO H Ei Ai 11111/./S1 I O.1131/ID/MO N' aN83'42'00-E 120.00' p 111 FENCE ON 6'W000 FENCE w Mg ,--.1 3, CORNER __ ___ __ g.,et 'm my NEW MACE 10 �7 1.OESxA a DOSING MOS NOMG S.GT. ELLEN G.111117IBR R�GK MING O V ♦L 1 C l TC t CP T 31: O REPLACE r.'INxx'vaL OAT. • / O o' • i O ST.AUGUSINE SOO POOL O M r 1♦m n� EQUIPMENT wv \ � ' � oPAD D GV(k1 I f war Ri11•1 A. r--. o = J \_r/ I nI MCNICHOLAS ELECTRIC METER— - i�� RESIDENCE z p EXISTING j ��!/) 395 12TH STREET u 0) POOL 4,0, p�� u: EXISTING HOUSE Co I w I 53 i8 (1/411116LIER I- LL[ , al ok-' ° g1l0.1 g� A 0 o z 0 (o)I. 0 IF 14 2 iv [-Existing location of fence _PROPOSED RELOCATION OF Co ERSTNG FENCE .,L p e� , 7FN ). ' i3-:e! "?.ia'�I I _o 23,ar_BUILDING RESTRICTION UNE 6 N ? y -11(.1,j'' 4.i. ....„ ( Og yrri s�, O ._N / 8 y FENCED RELOCATION N FOUND 1/2'IRON 4.4'NORTHWESTERLYp 0 0 IRMO= /OR: DATE „o O PENT: 8/12/19 —-- FOUND 1/Y IRON p / n M FOUND 1/2'IRON PENT: ; t PIPE.NO CAP SS3" J W 90.0✓ E.NO CAP (S83'42'00'W 90.18' FIELD) IAEE BflgVAL MIT EDGE OF PAVEMENT 11TH STREET _—_—_ CENTERI INF-—_— PROW? ACRD-RAMR: — --- - 1----- s. Mil=1 X6 S.F. ';• 1 \I. or1