Permit Int. Demo 299 Atlantic 2011 t":" .4 54' ` I\ CITY OF ATLANTIC BEACH
<, 800 SEMINOLE ROAD
J ` ATLANTIC BEACH, FL 32233
". INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002222 Date 6/16/11
Property Address 299 ATLANTIC BLVD
Application type description DEMOLITION
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
DEMO FOR INTERIOR BUILD OUT
Owner Contractor
JEFFREY SCHAEFER MASTER BUILDR
1414 PLAINFIELD AVE
ORANGE PARK FL 32073
(904) 635 -1236
Permit DEMOLITION PERMIT
Additional desc .
Permit Fee . . . 100.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 12/13/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 100.00 100.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 104.00 104.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 9 91 A 1-1--A ,tT1 L 01-9 Permit Number:
Legal Description Zao Parcel #
pJ Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ Soo Proposed Work heated /cooled 2-00 0 non- heated /cooled
Class of Work (circle one): New Addition Alteration Repair Move emol pool/spa window /door
Use of existing/proposed structure(s) (circle one): Commercial Residential
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval # :per o O4JLi
For multiple products use product approval form
Describe in detail the type of work to be performed: pit 0 OF C rE ,, �) P ""•,-11-1A/ 6 /
A. '- God /36444,4 ,.vT /i• .2h_ ‘,../A-L.L. r
Property Owner Information:
Name: ii'1k H' - -' Mai? u' - Address: 1 O9 7 1 '® E) C,Dvi>=
City J im S 3A/ vru State Fe Zip Phone c5 '4) 13 - o 3 0 7
E -Mail or Fax # (Optional)
Contractor Information:
Company Name :Jfra -r 11.- sk#+Arzf . iwu- i -c ,1ak_ Qualifying Agent: 'd f P "-E Y 6.-- .Q- A.r"rr -L
Address: 14 r toF/t 0 Av6 - City O/,&'6 rl'" State re- Zip 3 2 '' 73
Office Phon 4'a4) L6 4 - 3/n6 Job Site / Contact Number 6 3- / Fax # ( 91 7 4 - 574¢
State Certification/Registration # C 6- G 01-2 0J8
Architect Name & Phone # J rjt..Y F- • .5 ,A ,42 d o 0.58 Z
Engineer's Name & Phone # h 04 4
Fee Simple Title Holder Name and Address R.40 L vly i i
Bonding Company Name and Address 4 4-
Mortgage Lender Name and Address Ara "lc
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 laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical ifork, Plumbing, Signs, Wells, Pools, F urnaces, Boilers, Heaters,
Tanks and Air Conditioners, etc.
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.
1 hereby certify that I have read and examined this . application and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, tate, or local law regulating construction or the performance of construction.
( i C
Signature of Owner Signature of Contracto
Print Name Vl? - I 3-1,---L r_' P 2 C) Print Name �. F - Glt A.
Sw• • s and subscrib =e b- e e me Sworl to and subscrib-d before me
thi J y if �.1/. 1%. _ I_ �-- --- -'-: - a - �t th • • 44 D. y of 20
SH IRLEY L 13' A
IL, f A I , • . DD 957760 t � .
Notary '�i I l C ,I k°i Bonded Piro Notary Public Underwriters "" ° . l ''' k, *: MY CO ISSION if DD 957760
f ;�-4 �'' Bonded h February ru Notary Public c Undenv ., - •
, , . • ised 01.26.10