Permit 335 11th Street IS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000332 Date 3/24/10
Property Address . . . . . . 355 11TH ST
Application type description DEMOLITION (ENTIRE BUILDING)
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 8200
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Application desc
demo house and driveway
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Owner Contractor
------------------------ ------------------------
WILSON, JR. , STEVEN B. ALLEN BUILDERS INC
355 11TH STREET 1304 ALVIS RD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32220
(904) 786-3382
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Permit * * * * ' ' DEMOLITION PERMIT
Additional desc . .
Permit Fee . . . . 100 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . - 9/20/10
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 100 . 00 100 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 100 . 00 100 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Mar 23 10 12:24p Information SystemsCITY 0 904-247-5845 P.1
BU"IWG ftRMIT APPLICATION
CITY OF ATLArmc BEACH
8W Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
lob Address: PermitNumber:
Legal Description Z-(o f- Parcel.#
Hoor Area of Sq.Yt—. SqTt
Valuation of Work 5- Proposed Work hiate&coeled 116114- n6n-heatedkooled
Chiss of Work(circle one): New Addition Alteration Rq3air Move I mol" pooltspa window/door
Use of eiristing/proposed strowture(s)(eirde one): Commerciud
If am existing structare,is a fire spriidder system installed?(Circle one):44wes�* a N/A
Florida Product Avmval#
For multiple products use product approval form
:)escribe in detail the type of work to be performed: ��I>le
CIAJ 40�"jt- e A'4!,
Property Owner Info ation:
.qame: �71ei-,vn 1-ilf---i Address: 3-rJ-
�ity Ail,tic 6---4 —StateaZip322-72 Phone
-:�Mail or Fax 9
.ontractoLr Inf
qrmation:
�ompany Name: d
Qualffying Agent
kddress: �3o �, 474�1,( City �j--i-Ile State Zj-D
3111ce Phone -2.&. -)Z2 lob Sitd Contact Number—S-jr j--4�r�,dr Fax#
;late CextificationAlegistration;ff e'6c C-5-2j-j'7
krchitect Name&Phone# I,-,-z4-
Sngineees Name&Pbone#
Fee Simple Title Holder Name and Address I
3onding Company Name and Address
qortgage Lender Name and Address-
Wication is hmby made to q&aika permft to do dw wm*and buWAniqu m k4caftd. I cer*Ad no war*<w kodkaan has cownencedprior to am
sivance qfaArmir and thar aff wor*vill be brmed to joee!the standards of aff kms regmWv-
Tcom(ruWqr;kAfsjurftd1cti0n. Me permit becomes null
(6, momft or if constrwden or i;��Lie or abandbn@�fhr a=od of x�&montin at an
P ju _ y time after
vork is commenced I understand t4w sepeuva pomits must be secuAedfor PAWWW,SIjiM 11 dk ftsk mmmm Do&ds,Heakm,
rax4s andAhr Condfthwem eft
WARNING TO OWNM: YOUR FAILURE TO RECORD A NOTICE OF
COMWENCE1WINT MAY RESULT IN YOUR PAYING TWICE FOR U%IPROVEMMNTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LUMER.OR AN ATTORNEY BEFORE RECORDING V06M NOTICE OF
COWUVIENCEMENT.
lids
to vio t*e
Irint Name Print Name OW-7"'011'2
)worti tp and subscri !d before,me S and sub befo me
his -V,I Day of .20 /0 this
L
�otary Public WAND". LITZ NotEW U
Notary Public,State of Florida
My comm.exp.July 24,2013
Comm.No.DD 899301
ATLANTIC BEACH BUILDING DEPT.
DEMOLITION PROPERTY OWNER
RELEASE FORM
Date:
To Whom It May Concern:
I /We the current property owners of Lot
Block
Legal Description of Property
AKA ell 4� oPr ee/-
(Address of-Pro-perty) have contracted with to have
to remove the
(Company Name)
(Single Family,Duplex,Commercial,etc.)
Prior to the construction of
As a condition of issuing the permit we agree to the following:
1. All utilities are to be located and clearly marked.
2. Once house is removed, lot is to be graded and leveled.
3. All construction debris is to be removed from the property.
4. Affected area is to have grass or seed in place.
5. Erosion control devices will be put in place and will remain in place until grass
has covered affected area or new structure is completed and landscaping is in
place.
!-S Vig n�—atu re ?/
Sigrnre
T14ISSPACEFOR CORDRWRIT
RDER'S USE ONLY
OWNEV/
Signed. 0
Date:
Before me this day of
Of Florida,has personally appeared in the County of Duval,State
WANDA B.LITZ Notary Public at Large,State of Florida,County of Du
Notary Public,State of Florida My commission expires- 1,/3
Personally Known: ��4
My comm.exp.July 24,2013 Produced ldentifica�jo—n. —
Comm. No. DD 899301
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEAM FL 32233
INSPECTION PHONE LINE 247-5826
CONTRACTOR ASBESTOS NOTIEFICATION STATEMENT
Date:
Building Permit#
V
Site Address: 41
Street city State Zip
104.1.10 Asbestos.The enforcing agency shall require each building permit for the demolition or renovation of an
existing structure to contain an asbestos notification statement which indicates the owner's or operator's responsi-
bility to comply with the provisions of s. 469.003 Florida Statutes and to notify the Department of Environmental
Protection of her or his intentions to remove asbestos,when applicable,in accordance with state and federal law.
469.003 License required.--
(1) No person may conduct an asbestos survey, develop an operation and maintenance plan, or monitor
and evaluate asbestos abatement unless trained and licensed as an asbestos consultant as required by this
chapter.
(2)(a) No person may prepare asbestos abatement specifications unless trained and licensed as an
asbestos consultant as required by this chapter.
(b) Any person engaged in the business of asbestos surveys prior to October 1, 1987, who has been
ied asbestos surveyor, and who
certified by the Department of Labor and Employment Security as a certif
has complied with the training requirements of s. 469,013(l)(b),may provide survey services as described
in s. 255.553(l), (2), and(3). The Department of Labor and Employment Security may,by rule, establish
violations,disciplinary procedures,and penalties for certified asbestos surveyors.
(3) No person may conduct asbestos abatement work unless licensed by the department under this
chapter as an asbestos contractor,except as otherwise provided in this chapter.
Contractor's Signature
22 day of A
Subscribed and sworn to before me this WIP personally appeared
who is personally known to me or
produced as identification, and who did/did not
take an oath.
WANDA B.LITZ
Notary Public,State of Florida
Notary Public Signature Seal my com"i.exp.July 24,2013
r,onim.No.DD 899301
FORM DATE: 10.01.2006 FORM: ASBCONTR