299 ATLANTIC BLVD UNIT 1 DEMO24-0022 Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
SOUTHCOAST CAPITAL
PRTNSHIP LTD 241 ATLANTIC BLVD JACKSONVILLE FL 32202-5018
COMPANY:ADDRESS:CITY:STATE:ZIP:
JADE BLUE SKY
CONSTRUCTION INC 2 VIEJO ST ST.AUGUSTINE FL 32095
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
172531 0000 ATLANTIC BEACH
TERRACE
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
299 ATLANTIC BLVD DEMO INTERIOR ONLY UNIT 1 - ANGIES SUBS -
INTERIOR DEMO $2000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
DEMOLITION 455-0000-322-1000 0 $100.00
PU REVIEW BUILDING MOD OR ROW 001-0000-329-1007 0 $25.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 2Issued Date: 10/15/2024
PERMIT NUMBER
DEMO24-0022
ISSUED: 10/15/2024
EXPIRES: 4/13/2025
DEMO PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $154.00
2 of 2Issued Date: 10/15/2024
PERMIT NUMBER
DEMO24-0022
ISSUED: 10/15/2024
EXPIRES: 4/13/2025
DEMO PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
9
J:, BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
City of Atlantic Beach Building Department
PERMIT# 0 .rnoz'1 - ObZZ
lair- 800 Seminole Road, Atlantic Beach, FL 32233
ALL information required to process
ri `'.Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address Z'j ienzm i7/C /5G yr) 7--C. igCI•{Un `+ 1 RE#
Legal Description > E A jtla-/&j
Valuation of Work(Replacement Cost) 4 Zpc)d' Heated/Cooled SF Non-Heated/Cooled SF
Class of Work: New Addition Alteration Repair Move Egtbemo Pool Window/Door
Use of existing/proposed structure(s): gi.Commercial Residential • If existing structure, is a fire sprinkler system installed?:YesEtNo
Will tree(s)be removed in association with proposed project? Yes (Must submit separate Tree Removal Permit)ZI,No
Describe in detail the type of work to be performed:
n/#vd/Z oz-rn a i i" P/S E frd't afSTAI4/0.1 3U1 GO d(/j
Mix,— 57/2 OCrLig/
Florida Product Approval#For multiple products use Product Approval Information Sheet)
Property Owner Information Name $o,Tl,(Ca Csarmt /!sirs//// Phone goy 6.74i_ 366e,
Address 214 017/,9,t'1K /3&/K2 City it,erga/+-i, Aey State R._ Zip 52,26 c,
Email Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Ago awe--n- /1
Contractor Information Name of Company /iD -8 ii.eve: sky evN-ci,2 ' Pa//Phone goy SOC --gd/q
Address 2 v/5JO 57/er"
7//
City ST Ari(i-State,r-c Zip 324, r
Qualifying Agent 4'/a/,9,ri c.)92Q^/ State Certification/Registration# (&C /so''7U
Email /J/,L&g,E cidi coe.,cretc'Igoe_Co 141 Job Site Contact Number go/ bcc:, q 0 / c-
Worker's Compensation Insurer OR Exempt E, Expiration Date //2. /2c—
Architect's Name Email Phone
Engineer's Name Email Phone
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 city/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 YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT
MUST BE RECORDED AND POSTED ON THE SITE OF THE IMPROVEMENT BEFORE THE FIRST
INSPE TION. IFS( U INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
FORE •RDI G YOUR NOTICE OF COMMENCEMENT.
Signature of Owner o gent) Signature o or
Signed and sworn to(or affirmed) before me this 2' day of I ed a sworn to(o . ed)before me this Z3_day of
Cp}CIMbeY , 'L0 by IN• Ir4- fl by v Ton / Lr
ta rh
4111SignatureofNota
1
Signature of Nary SZ_ -
v(Personally` wn OR Produced Identifict cn Versonalft Know OR [ ] Produced de ification
Type of Identificatio ;te :'4
ASHLEY ANN HOLMES Type ofidentif,icat•o •
iti ' MY COMMISSION#HH 412785 t
TONI GINDLESPERGER
FOF;F,',P•'• EXPIRES:October d,2027
i; MY COMMISSION#HH 407122
7:4‘.
0X1
gyEXPIRES:October 6,2027
f of •'
x=
EXHIBIT A
LEGAL DESCRIPTION OF THE ATLANTIC BEACH PLAZA
Those lands described in Official Records 6675, Page 283, Duval County, Florida, being the southerly 15'
of Lot 7, all of Lot 8, and that certain unnumbered lot or strip of land, lying south of Lot 8 between said Lot
8 and Atlantic Boulevard, as recorded in Rat Book 5, Page 69 of said Public Records, together with Lots
1,2,3,4.5 and 6, Atlantic Terrace, as recorded in Plat Book 15, Page 34, of said Public Records, together
with that certain 15 foot alley bounded on the north by the south line of Lot 5 and 6 and on the south by
the north line of Lots 1 through 4.
51