1830 Seminole Rd DEMO22-0021 DEMO PERMIT PERMIT NUMBER
q CITY OF ATLANTIC BEACH DEM022-0021
° ISSUED:9/14/2022
800 SEMINOLE ROAD EXPIRES: 3/13/2023
ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814
Y 4 PM FOR NEXT DAY INSPECTION.
ALL • • • • . • • •• I OF • • • • BUILDING
CODE, NEC, IPIVIC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
rIn addition to the requirements of this permit,there may be additional restrictions applicable to this property
y be found 1n the public records of this county,and there may be additional permits required from other
ental entities such as water management districts,state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUEOFWORK-:
INTERIOR DEMO FOR
1830 SEMINOLE RD DEMO INTERIOR ONLY ENGINEERING $1000.00
TYPE OF ZONING: SUBDIVISION:SE
CONSTRUCTION: NUMBER: GROUP:
172020 0510 SELVA MARINA UNIT 09
COMPANY: ADDRESS:
OSBORN BUILDERS LLC 2157 POINCIANA RD NEPTUNE BEACH FL 32266
OWNER: ADDRESS:
ANDREW BRYANT 1830 SEMINOLE RD ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT I�
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.
LIST OF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
FEES
DESCRIPTION ACCOUNT I QUANTITYI PAIDAMOUNT
DEMOLITIOry 455-0000-3231000 0 $100.00
STATE DBPR SURCHARGE 455-0000808-0]00 0 $300
STATE DCA SURCHARGE 455-0000-308-0600 0 $300
TOTAL:$104.00
Issued Date:9/14/2022 1 of 2
•'. 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
Phone: (904) 247-5826 Email: Building-Dept0coab.us IS REQUIRED.
AMsn
Job Address:
i$3oxMla.� Permit Number:wr
1"OZZ-o�Z L
LC'
Legal Description �ZD og-ZS 7rr1 E. I/Ott 5 REN 17�.02��P�
Valuation of Work(Replacement Cost)$IM," _Heated/Cooled SIF Non-Heated/Cooled
• Classof Work: ❑New OAddition DAlteration ❑Repair ❑MovL
e Demo ❑Pool E]Window/Door
• Use of existing/proposed structure(s): DCommercial tResidential
• If an existing structure,is a fire sprinkler system installed?: Oyes 13No
• Will tree(s)12 r mov in aiati n with proposed project?DV mus submitseparateTree Removal Permit) N
Describe in detail the type of work to beperformed
: ap,rL�[ }p Qp lLf2.
��s/+I"�s�Y�we(aYruYr•Fs (r�adr,6ikchgnYl�` r �•ccrCcKltt+L+� +"
Florida Product Approval N for multiple products use product pprovpal form
Property Owner Information
Name T Address PfMGLYe.vr�'
Ciry nG State Zip �y�� Phone �
E-Ma I� r� nf' ysd CI"rt
Owner or Agent(If Agent,Power o Attorney or Agency Letter Required)
Contractor Information la'(OR
Name of Company 92eA0w2v 8 Qualifying Agent �Aa'
Address CityjoiL >rar�/r Statte — dip 3
Office Phone ry T �7 lob Site Contact Number
State Certification/Registration N E-Mail yT'Q
Architect Name&Phone N Y:•1 �...i diirL
Engineer's Name&Phone N
Workers Compensation Insurer OR ExemptA 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
RECO DIWYOUR NOTICE OF COMMENCEMENT.
11 Signature of Owner or Agentl 44t
(Signature of Contractor)
Signed and sworn to(or affrmed) tome this day of Si nesworn t r affirmgQ,lbefor tl 's/ `11ay of
AW. 20i ,by
'
ROBERT DURIbf+ r N 9Z lnr:S3NldK3 " •':: •...v
tayV tMW fiN1N01SSINN07!.N
*ermnally Known o ;y; E%PYiES.kiy M,701k+w XPersonally Known OR NInahU !"1a3g0+!
I l Produced dentifica " .indYliru KaYrPWclNt�t' ( ]Produced Identification
Type of Identification' _ Type of Identification: