Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
1653 N LINKSIDE CT DWAY21-0026
rt'r"'r1" � 'i Updated 10/9/18/ Building Permit Application **ALL INFORMATION HIGHLIGHTED IN GRAY/ Cityof Atlantic Beach BuildingDepartment IS REQUIRED. 800 Seminole Road, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us a Ft 3223-3 - Job Address: 1 ko s3 (rt,r`K-5;cQ Q. C . . ,,t_ jG de-A-4--permit Number: k---)04 Z 4 Legal Description \Ja I--`4-‘Ksuke 0n; t 2- Lot I13 RE# 317y - o I1a5 Valuation of Work(Replacement Cost)$ g l'l OO Heated/Cooled SF Non-Heated/Cooled__ • Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool EWindow/Door • Use of existing/proposed structure(s): ECommercial ❑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) x11 No Describe in detail the type of work to be performed: Florida Product Approval# for multiple products use product approval form Property Owner Information Name Susan Vanlierop Address 1 653 Linkside Court North City Atlantic Beach State fl Zip 32233 Phone 904-910-9248 E-Mail threetripletsmom@aol.com Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Susan Vanlierop Contractor Information Name of Company Qualifying Agent Address City State Zip Office Phone Job Site Contact Number State Certification/Registration# E-Mail Architect Name& Phone# Engineer's Name& Phone# Workers Compensation Insurer OR Exempt E 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 RECOR UR YON� TE O COMMENCEMENT. Signature of Own or Agent) ( ) 'gned and swornfor ffir ed before me th' Od y of -2 Z- �.y A.�I..r .A G V• v, 'e'rb 1 re :Met 4 [ ]Personally Known OR •t; :_,'•••., TONI GINDLESPERGER [ ]Produced Identification '_� `= MY COMMISSION#GG 353178 Type of Identification: ----f4,,'," EXPIRES:October 6,2023 ';Fps F° Bonded Thru Notary Public Underwriters (Signature of Contractor) Signed and sworn to(or affirmed)before me this day of , by (Signature of Notary) [ ]Personally Known OR [ ]Produced Identification Type of Identification: :-tom Owner Builder Affidavit **ALL INFORMATION ,'s HIGHLIGHTED IN r `"� City of Atlantic Beach Building Department GRAY IS REQUIRED. T. 800 Seminole Rd, Atlantic Beach, FL 32233 -�-0131~ v Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES OWNER/ BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU, AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. . III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT (904- 247-5826 OR BUILDING-DEPT@COAB.US ) IF IN DOUBT. V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. Job Address: 1653 Linkside court north Atlantic Beach, FL 32233 Owner Name: Susan Vanlierop Phone Number: (904)910-9248 Mailing Address: 1653 Linkside Ct. N. City: Atlantic Beach State: fl Zip: 32233 Notarized Signature of Owner__ - `** Th egoing inktrument was acknowledged before me this;37ay of 6 `< , 202 in the State of Florida, County of VV0.-I Signature of Notary Public \ [ ] Personally Known OR [ ] Produced Identification( Type of Identification: [Th l `-- ,,:p 4 TONI G! �i)LESPERGER Updated 10/24/18 *7 `c*: MY COMMISSION#GG 353178 ',..............--. .'3.` EXPIRES:October 6,2023 ••%FBonded Thru Notary Public Underwriters s'--L1r, RIGHT-OF-WAY/EASEMENT PERMIT APPLICATION **ALL INFORMATION 2 ,9 `' Cityof Atlantic Beach HIGHLIGHTED IN GRAY IS 800 Seminole Road,Atlantic Beach, FL 32233 REQUIRED. PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES Job Address 1653 Linkside Court North,Atlantic Beach,FL32233 Permit Number Contractor Information CompanyOld Stone Pavers Qualifying AgentJorge Pereira Address4569 Caraway Drive cityJacksonville State FL Zip32257 Phone(904)588-8105 Email ospavers.com State Certification/Registration#Owner-Builder Permit Architect Phone Email Engineer Phone Email Workers Compensation Insurers OR Exempt❑Expiration Date • 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 Susan Vanlierop (Project Superintendent) with (Company Name) Property Owner Phone(904)910-9248 • 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 40 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 expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. • The f Works Director shall be notified 24 hours prior to starting work and again immediately u on completion. `//�� Date & 30/7 Permittee(signed in presence of Notary P lic) STATE OF FLORIDA,COUNTY OF DUVAL The foregoing instrument was acknowledged this day of Q A ,20 Z ( , by 5-%-)S.1n lagNt1e__ vgrt 1 t-er ,who personally appeared before me and (printed name of Prmittee) _ ackno1.ged tha e/s signed the i strument voluntarily for the purpose expressed in it. TONT GINGLES''ERGER 2°' °�: MY COMMISSION#GG 353178 ' ' EXPIRES:October 6,2023 ±; � REVOCABLE ENCROACHMENT AGREEMENT .•, **ALL INFORMATION City of Atlantic Beach 800 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 Susan Vanlierop 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 Replacing driveway via removing driveway dement and installing Pavers 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 1653 Linkside Court North,Atlantic Beach FL 32233 • 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 assumed by the USER. �iisof Date d(a/30/240 2/ Property Owner/Agent (signe In presence of Notary Public) STATE OF FLORIDA, COUNTY OF DUVAL The foregoing instrument was acknowledged this no day of c c , e , 20 74, by t5o San Ica At. Van ket'oe , who personally appeared before me and ,,rinted name of Signer) ac • ledged t►,L she si: ed the instrument voluntarily for the purpose expressed in it. TOtJI GINDLESPERGER Department Approval: S�pY PU S' !re of Notary Public,State • lorida °' MY COMMISSION#GG 353178 v EXPIRES:October 6,2023 [ ] Personally Known Q` IO. ?cnded Thru Notary Public Underwriters [ ] Produced Identification (Type) I__.-: - cott Williams, Public Works Director H:\Applications&Forms\Word Documents\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18 9661 p1Hao,D ) /4/4YON 1ono, 3d/SNN!7 w • y �s s ,OG" GS=N.Oc;71:68S 'vv!' ,oiN,oi MI i7 �d IZ'�74 O ^ ?' .t' • • • i = ,LV vit ;d jr_ '- - ' } •,, ,---f_ . z .. , , ,,r, 1,- .....--, 1:::•4 It'r7,07 V? Y9t 5•1 ._..- .4', ' '. ',. .ftl• flii . 4 t ‘t, k .10 OW v • A'" 'O©%! (#Z'fi)7r10021 MA ,00'11 N. ;oo;9L 'N m-.t•° `� . n ` �n y r 59.1d7..S/ V �. ; - 0 o 9�i7»iut7 n^y oa�nts ,cd�ts•/ t 0a �. �. ° 1•• y; a ,J. , ictu., � • Oil ed ; �0.13'd'�1'M7 -i\ i,�y a oo..o_ p J - r -4 7 i/G i6S ',let/ 7.00.1$,g L � i vT M .r sdi 6a 3�n�rra 'minas a s/n'. We h '�G/ ND/t39s JO _It�b'd ' ',7/V/ '-g 77/4/vQ9)/2//' ado g71/1 IZIer!>sg1 ' 'o, A.!/rerd6'nv A a71 cltlI :0ialigefi doo'/7Nt/A 7) /vb'Sf7' : 01 Vb3'/d tl z:iaC 'Nrn14'O (A A',) 7 V.71.11Y.V Puadoaa 7 W0/1AIN 01 a.0. 4 al 041) :Sht/1 NMOtff 5/YOu,Lb'Ag1R Wld Q3N0I1N3Y4 3AOOV 31-11 NO Q3SY 3li9 V NO3l13H NMOHS SONiuvse .310N , /*leifya4C4iN L7 591TG1'i X52NN,7 1/oj Yld '00 1YAI1O 30 SC1U033ki 3118f1d 1N31:18f10 31.41 dO y6) S3OYd 1 , - )1009 1Vld NI 13308033d Sb 2 .L/N/7 ..Y0/.VIN/ 7 b'A 77S dO dVW NO NMOHS SV — NO018 Ey/ 101 AO A3A JflS AuvaNfl08 ENIMOHS dVW . .4411"4" eas,,,..., Nosadla ei:i i 96, 20 Abw COd 618 t