163 Belvedere St DEMO23-0027 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
MODC INVESTMENTS LLC 98 ORANGE ST NEPTUNE BEACH FL 32266
COMPANY:ADDRESS:CITY:STATE:ZIP:
KLT CONSTRUCTION, INC 1951 OCEAN DR S #1A JACKSONVILLE
BEACH FL 32250
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170583 0000 SALTAIR SEC 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
163 BELVEDERE ST DEMO COMPLETE DEMO HOUSE $15000.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 PUBLIC UTILITIES UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL
Notes:
Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is
needed, call 247-5878. State Law requires calling Sunshine 811 to have ALL public utilities located BEFORE beginning the work.
2 PUBLIC UTILITIES DISCONNECT AND CAP INFORMATIONAL
Notes:
Disconnect and cap water and sewer lines. Capped sewer line must be located at property line and standpipe must be visible above ground level.
Failure to follow these conditions may result in failed inspections and additional fees.
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 3Issued Date: 9/5/2023
PERMIT NUMBER
DEMO23-0027
ISSUED: 9/5/2023
EXPIRES: 3/3/2024
DEMO PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
3 PUBLIC UTILITIES INSPECTION PRIOR TO DEMOLITION INFORMATIONAL
Notes:
MUST CALL 247-5814 FOR A PRE-DEMO INSPECTION OF THE DISCONNECTED AND CAPPED WATER AND SEWER LINES PRIOR TO DEMOLITION. Failure to
follow these conditions may result in failed inspections, additional fees and Stop Work Orders being placed on future development.
4 PUBLIC WORKS REMOVAL OF TREES INFORMATIONAL
Notes:
A tree removal permit is required for removal of any trees 8 inches in diameter at breast height and greater. Removal of trees without a permit will
result in double mitigation and application fee.
5 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL
Notes:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line (904-247-
5814) to request an Erosion and Sediment Control Inspection prior to start of construction.
6 PUBLIC WORKS DUMPSTERS/ROLL-OFF CONTAINERS INFORMATIONAL
Notes:
Dumpsters and roll-off containers must be used in compliance with Section 16-8 and must comply with all standards, per City code.
7 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
8 PUBLIC WORKS CONSTRUCTION SITE MANAGEMENT INFORMATIONAL
Notes:
Provide construction site management plan, including location of silt fence, dumpster, portable toilet. Right-of-Way Permit is required if using right-of-
way for construction parking.
9 PUBLIC WORKS SLAB DRIVEWAY REMOVAL INFORMATIONAL
Notes:
Slab and driveway to be fully removed.
10 PUBLIC WORKS GRASS INFORMATIONAL
Notes:
Full site to be grassed.
11 PUBLIC WORKS REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
12 PUBLIC WORKS DEBRIS REMOVED INFORMATIONAL
Notes:
All construction debris must be removed from job site by Contractor.
13 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
2 of 3Issued Date: 9/5/2023
PERMIT NUMBER
DEMO23-0027
ISSUED: 9/5/2023
EXPIRES: 3/3/2024
DEMO PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
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
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $154.00
3 of 3Issued Date: 9/5/2023
PERMIT NUMBER
DEMO23-0027
ISSUED: 9/5/2023
EXPIRES: 3/3/2024
DEMO PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Final Plumbing
Final Electrical
Final HVAC
CC Final
Final Building*
Swimming Pool Steel
Swimming Pool Safety
Electrical Grounding & Bonding
Swimming Pool Final (Bldg)
Swimming Pool Final (PW)
Formed Columns/ Beams*
Masonry Cell Fill
Structural Steel*
OTHER:
OTHER:
OTHER:
OTHER:
OTHER:
Power Pole
Silt Fence
Piers/ Stem Walls
Underground Plumbing
Underground Electric
Foundation/ Footing
Slab**
Retaining Wall Footing
Driveway
Sewer (Building Dept)
Sewer Tap (Utilities Dept)
Rough Electric*
Rough Plumbing/ Top Out*
Rough Mechanical*
House Wrap
Wall Sheathing
Roof Sheathing
Tie-down Framing Connections
Rough Framing
Roofing In Progress
Window/Door In-Progress
Insulation Ceiling
Insulation Wall
Exterior Lath
Stucco Scratch Coat
Exterior Siding In-Progress
Brick Flashing & Ties
Early Power
Gas Rough
Gas Final*
* When all rough electric, plumbing, mechanical are complete but before any work is
covered up.
* When all gas piping is complete and wallboard is installed but before gas is
attached to any appliance. All outlets must be capped and pipe pressurized at a
minimum of 15 lbs.
* For new living space: When all construction work including electrical, plumbing,
mechanical, exterior finish, grading, required paving and landscaping is complete
and the building is ready for occupancy, but before being occupied
Additional inspections may apply to your project if your project
contains these elements:
INSPECTIONS REQUIRED FOR BUILDING PERMITS
To verify compliance with building codes, inspections of the work authorized are required at various points of the construction.
The following inspections are typically required for residential projects:
Date: Initial: Date: Initial:
_____________________________________________________
Permit Type
____________________________________________________
Permit No.
__________________________________________________________
Job Address
____________________________________________________
Contractor
POST THIS CARD WITH PERMITS AND PERMIT
DOCUMENTATION IN FRONT OF BUILDING
Construction Hours per City Code: 7am—7pm Weekdays; 9am—7pm Weekends
Building Department Public Works/Utilities Fire Department
Phone: 904-247-5826 Phone: 904-247-5834 Phone: 904-630-4789
Fax: 904-247-5845 Fax: 904-247-5843 Fax: 904-630-4203
* When forms and reinforcing steel, anchor bolts, sleeves and inserts, and all
electrical, plumbing and mechanical work is in place, but before concrete is poured.
* When all structural steel members are in place and all connections are complete,
but before such work is covered or concealed.
** FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION
DEMO HOUSE
163 BELVEDERE ST
KLT CONSTRUCTION, INC
DEMO23-0027
S` `ik„ BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
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City of Atlantic Beach Building Department PERMIT# ;t mpZ3 OZ7s,
800 Seminole Road, Atlantic Beach, FL 32233
ALL information required to process
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Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address 23 36) ,v6.-pee- -e _‘- A/t nc 404 t 3L RE# 1-703-1b3 _DOOo
Legal Description I b_8 i 7 -vS 'PM __ 1(.,-TA IIC St1( f £()( S Q 7 ..S-9 1
1
Valuation of Work(Replacement Cost) t.5-00,C)Heated/Cooled SF Non-Heated/Cooled SF
Class of Work: New Addition Alteration Repair Move 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 project? Yes(Must submit separate Tree Removal Permit) No
Describe in detail the type of work to be performed:
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Florida Product Approval# For multiple products use Product Approval Information Sheet)
Property Owner Information. Name - > c„.. I JV6ST-n-,a(jTS Phone qj v t(--`e&t•5ii`ie
Address 9 15 ()Q Gg., s----;City iVe 2p j( (),,-1,(tj State qL- Zip 7 ZZtot„
Email Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information Name of Company
ftLU (ices jt iy pvC Phone qPt /f - 't, s
Address ID- (;o/a ti/ /n City
1/47/
pe. 0,644 State r'- Zip ?'Z-S
Qualifying Agent )Ct,,\f l W uv j/-L.1 State Certification/Registration# C4 'C( Z5 h j---7,c
Email , )(/-j-c, yl S f'I/( -/p,,,Np al-f;ii /- Job Site Contact Number qo --g — 0 lj i
Worker's Compensation Insurer
V
OR Exempt Expiration Date 7//5-1/4..„1/
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 maybe 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 YOU 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.
A.
Signature of Owner or Agent)
c
Signature of ractor)
Signee/d and sworn to(or afffiir med)before me this day of Signed anii'sworn to(or affirmed)before me this /1) day of
AV-4,2D2 by V Zirk; by 4svl,.W (444 4
Signature of Notary _ v R Y /J s3ipnat a of Notary QV ys . •. . /,
Expires- .- 1Thsonally Known OR [ ] Produced Id cat 312p 6` Personally Known OR [ ] Proctued Id of; ;,+. .0'
Type of Identification: CO TrenB Ra
T9f Identification:
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MAP SHOWING BOUNDARY SURVEY OF:
LOTS 593 & 594, SECTION NO. 1 SALTAIR, ACCORDING TO THE PLAT THEREOF,
AS RECORDED IN PLAT BOOK 10, PAGE 8, OF THE CURRENT PUBLIC RECORDS OF
DUVAL COUNTY, FLORIDA, IN SECTION 17, TOWNSHIP 2 SOUTH,
RANGE 29 EAST, OF SAID COUNTY.
CERTIFIED TO: JWB REAL ESTATE CAPTITAL
LEGEND:
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NOTES:k , .....•_,A.s
1. BEARINGS SHOWN HEREON BASED ON STATE PLANE COORDINATES (1983/2011) WITH THE BEARING ON THE EASTERLY RIGHT-OF-WAY
LINE OF BELVEDERE STREET BEING NORTH 22'04'01" EAST.
2. ELEVATIONS SHOWN HEREON BASED ON NORTH AMERICAN VERTICAL DATUM OF 1988 PER TRIMBLE VRS NETWORK WITH AN ORIGINATING
BENCHMARK BEING A SET NAIL AND DISK STAMPED 'GAI TRAY.", WITH AN ELEVATION OF 9.00 FEET(SHOWN HEREON).
3. THIS PROPERTY APPEARS TO LIE IN FLOOD ZONE "X" WHICH IS AN AREA DETERMINED TO BE OUTSIDTHE 0.2% ANNUAL CHANCE
FLOODPLAIN, ACCORDING TO COMMUNITY PANEL 120075-0409-J OF THE FLOOD INSURANCE RATE MAPS FOR THE CITY OF ATLANTIC
BEACH, DUVAL COUNTY, FL, DATED NOVEMBER 2, 2018 AS PUBLISHED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY.
4. THIS SURVEY WAS PERFORMED WITHOUT THE BENEFIT OF A TITLE COMMITMENT. THERE MAY BE EASEMENTS AND/OR RESTRICTIONS
RECORDED IN THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FL AND NOT SHOWN HEREON.
5. ALL LIVE OAKS AND LONGLEAF PINES ARE MARKED. ALL OTHER OAKS ARE SCRUB, WATER, OR LAUREL. ALL OTHER PINES ARE SLASH
OR POND.
6. THIS PROPERTY IS ZONED RESIDENTIAL SINGLE-FAMILY(ARS-2). d.l) MINIMUM LOT AREA: 7,500 S.F.; d.2) MINIMUM LOT WIDTH: 75
FEET; d.3) MINIMUM LOT DEPTH: 100 FEET; e) MINIMUM YARD: 1)FRONT: 20 FEET, 2) REAR: 20 FEET, 3) SIDE: COMBINED 15 TOTAL
FEET AND 5 MINIMUM FEET ON EITHER SIDE; f) BUILDING RESTRICTIONS: 1) MAXIMUM IMPERVIOUS SURFACE: 45%, 2) MAXIMUM BUILDING
HEIGHT: 35 FEET ALL PER THE LAND DEVELOPMENT CODE FOR THE CITY OF ATLANTIC BEACH, FLORIDA.
LEGEND: SCALE 1"=20' I HEREBY CRRTIOY THAT THIS SURVEY MEETS THE STANDARDS OF
gai consultants PRAE GCE AS SST FOR 114 EY THE FLORIDA BOARD OF SURVEYORS
1301 Ri verp laco Boulevard,Suite 900
MAPPERS PUNSUANT TO CHAPTER•>2.02)OF THE FLORIDA
lackaoovilfe Florida 3220' STATUTES AND 51-1r of THE FLORIDA ADMINISTRATIVE CODE.
www.gaiconsultauts.comwww.gaicoRSultaata.com
OB NoiiLB3604ENGINEERING•PLANNING•SURVEYING•CEI SERVICES B160030 DATE NOV.23,2020 JOSEPH K.LEK FLA.P.S.M.CERT.NO.LS 6016
NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED PROFESSIONAL SURVEYOR AND MAPPER
m000 c o1
O c o o 3 c" Permit Number Tax Folio Number 765 83-
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F (-0 NOTICE OF COMMENCEMENT
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STATE OF FLORIDA
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THE UNDERSIGNED herebygives notice that improvement will be made to certain real property,and inuNP
c K 9 accordance with Chapter 713,Florida Statutes,the following information is provided in this Notice of
i N Commencement.
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Oc 2 1. Description ofproperty(Streetaddress): )L3 Btkie pie ¶ 4Tt.raflr' ecn CA.377,73
2. Legal Description: lb—' g7— ?. c 2,1 1d t"-t r S Lt
Oc 9.13. General description of improvement: lIeA^ib St t Ltryt 1 Ly (1"S t esti
D
r 4. Owner information:
LLCa. Name and Address: a Si ry e.S r rr.t. LLC
b. Interest in property: Oyp ,p
c. Name and address of fee simple titleholder(other than owner):
5.a.Contactor's name and address:_KLT Construction Inc.-Kevin Hensley 15 Fairway Rd.Jax Beach FL 32250
b. Phone number: 904-813-8613 Fax number:
5. Surety Information:
a. Name and address:
b. Phone Number: I Fax Number:
c. Amount of Bond:
6.a.Lender's name and address:
b. Phone Number:
7.a.Person within the State of Florida designated by Owner upon whom notices or other documents may be
served as provided by 713.12(1)(a)7.Florida Statutes.
a. Name and address:
b. Phone numbers of designated person •
8.a.In addition to himself/herself,Owner designs of
to receive a copy of the Lienor's Notice as p vided in Section 713.13(1)(b),Florida Statutes.
b. Phone number of person or entity designated by owner:
9. Expiration date of notice of commencement(the expiration date is one(1)year from the date of recording
unless a different date is specified)
WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNERAFTER THE EXPIRATION
OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER
CHAPTER 713,PART I,SECTION 713.13,FLORIDA STATUTES,AND CAN 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 COMMENCING WORK OR RECORDING YOUR
NOTICE OF COMMENCEMENT.
Signa of Owner wner's Authorized Officer/Director/Partner/Manager:
Signatory's Title/ ffice)
The foregoing instrument was acknowledged before me this Z 3 day of 202.3
b}0 pjS[0pas rJt,,/p/e1/L for LS dlit1s$ '/'c 00t1iiuii„,,
Notary: Zl.l' Q PR
pe20P2ig5ne:.--::
35res
4`
0/31
Personally Known Or Produced Indentification` entification Produced: TrenaRa
My commission expires:Q
My Commission
HH 192509 *.••Z
Underr penalties
best
of perjury,I
dand belief.
declare
chave
read the foregoing and that the facts stated in it are 'ii` /O Q
true the
i,nut