1823 SELVA GRANDE DR DEMO23-0001 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
SADOSKY LINDSEY NICOLE 1823 SELVA GRANDE DR ATLANTIC BEACH FL 32233-4526
COMPANY:ADDRESS:CITY:STATE:ZIP:
BOSCO BUILDING
CONTRACTORS 2158 MAYPORT RD ATLANTIC BEACH FL 32233
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169542 5038 SELVA TIERRA
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1823 SELVA GRANDE DR DEMO PARTIAL REMOVE BACK PORCH AND
INTERIOR $8000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
DEMOLITION 455-0000-322-1000 0 $100.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $129.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 2Issued Date: 1/25/2023
PERMIT NUMBER
DEMO23-0001
ISSUED: 1/25/2023
EXPIRES: 7/24/2023
DEMO PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 1/25/2023
PERMIT NUMBER
DEMO23-0001
ISSUED: 1/25/2023
EXPIRES: 7/24/2023
DEMO PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
i`';a° IS REQUIRED.Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: I 2--i S Gt//q ,{ /tr1/1/o e- P/c Permit Number: 1Z.Ia-SA I, •.L7
Legal Description 33 1a.zi' - Sfi/l/ -7/,6' 4 RE# /G I 3
Valuation of Work(Replacement Cost)$ a' /4 Heated/Cooled SF Non-Heated/Cooled
Class of Work: New Addition Alteration Repair Move xi Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial Residential
If an existing structure,is a fire sprinkler system installed?: Yes No
Will tree(s) be removed in association with proposed proiect? Yes(must submit separate Tree Removal Permit) No
Describe in detail the type of work to be performed: 2E74/ l3_4 c KC /°O&-C6,
i°ee-c/se.-- 4 oric y (rezjV 6 f
x,02 r fes,
Florida Product Approval# _for multiple products use product approval form
Property Owner Information
Name /1, C f-/)t-4- Ge: Address i 7-: .54-'4 /9 el•-1igs,/DG
City / TL-4W is t N State y'` Zip -'3 - )-33 Phone ,1- ?f -7UY-
E-Mail /'7iR97 7: /1,a,
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) -77s 1)
Contractor Information
Name of Company t3Q)CC 1.3t-V1' Qualifying Agent 9ibf/ BJLo
Address 2-/s. y/90I;'l / ) City ^tc.,JeSU.n' 1/,)1-to State /"-'' Zip 1-7. 3-
Office Phone Ci( .4--—•1/- v i 2-C Job Site Contact Number ,e4.- X37 -t'Seo '-
State Certification/Registration# C 0-5.'c -/?-- E-Mail `t" /C10E (i:'c Cc,.1
Architect Name&Phone#
Engineer's Name&Phone# -
Workers Compensation Insurer MA,,21 y I _S.4 4r7ce OR Exempt Expiration Date III ' 7-1-
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 FIN , CIN e, CONSULT WITH YOUR LENDER OR AN ,TTS ' N . BEFORE
RECORDING F MENCEMENT.
111111111P-Lam'
Signature of Owner or Agent)Signature of Contractor)
P i
Signed and sworn to(or affirmed)before me this f=4kday of Signed and sworn to(or affirmed)before me this /54 day of
3/-1-/od-i;/ ad)3 ,by j 17n ,i r'lc c 1/44 ,Jl'f , .tea ,by 7 U'Op /i Ai:
Signature of Ndtary) Signature of Notary)
arc tt WILW W L.POPE
pf Personally Known OR •. ' ;. MYCOMMISSION#G(i348645 j Personally Known OR wee:., WILLIAM L.POPE
o: EXPIRESmix, :October 19,2023ProducedIdentificatio : of o:,,public unds I Produced Identification :4i As s MY COMMISSION#GG 348645
Type of Identification:Type of Identification:w: EXPIRES:October 19,2023
oli o•`Bonded Tlw Nobly Pubrec Undelw'Es
By Mike Jones at 10:14 am, Jan 05, 2023
REVIEWED FOR CODE COMPLIANCE