Permit 1870 Francis Ave { CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
f, INSPECTION PHONE LINE 247-5826
Application Number 06-00031981 Date 1/10/06
Property Address . . . . . . 1870 FRANCIS AVE
Tenant nbr, name . . . . . DEMOLISH 2 WOODEN BUILD
Application description . . . DEMOLITION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . 0
Owner Contractor
---------------- -------- ------ ------------------
BEACHES HABITAT REALCO WRECKING CO.
1870 FRANCIS AVENUE 8707 SOMERS ROAD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32226
(904) 955-3581
------------------------ ----------------------------------------------------
Permit . . . . . . DEMOLITION PERMIT
Additional desc . .
Permit Fee . . . . 100 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
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.
BUILDING OFFICIAL
CITY OF ATLANTIC BEACH
DEMOLITION PERMIT APPLICATION
�VJ35>�
Date:
Job Address: 1 2 ?v FRS G(5 A J c-
Owner of Property: C 1,n NES )1-,-a o TR r
Address: )6? FQApc,» A,)C, A ri, 9e->+, .52.233 Telephone: 2$l-)'Z'L2
Legal Description: Block Number: Lot Number:P-ff D� 17 Zoning District:
Contractor: Regl-cn 'i2,--,`/c L►►-1I C�• State License Number: CGC 055166
Contractor's Address: 17 v7 54 jcf-PJtct= f't- 322'1-6
Telephone: qct/ - 7s'7 - 7 3>I Fax: 90�/- T�- 6 11
Describe proposed use and work to be done: x ,
Present use of land or building(s): r-
Is approval of Homeowner's Association or other private entity required? Ala If yes, please submit with this
application.
Willthis project involve changes in elevation, site grade or any use of fill material or the removal of any trees?
NO. Applicant certifies that no change in site grade or fill material will be used on this project.
❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building
Permit.
O�INO. Applicant certifies that no trees will be removed for this project.
❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree
Removal Permits to be reviewed by the Tree Conservation Board, which meets two times each month.
Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate.
Incomplete applications may result in delay in issuance of permit.
STEP 1. Attach Tree Removal Application if trees are to be removed or relocated.
I hereby certify that all information provided with this application is correct. J l
Signature of Owner: i' Date: 2-/ Z / S
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and
ordinances governing this type of 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 federal,state or local rules,regulations,ordinances,or laws in any manner,including the
governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the
above information being true and correct and that the plans and supporting data have been or shall be provided as required.
800 Seminole Road •Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 •Fax: (904)247-5845 • http://www.ci.atlantic-beach.fl.us
Page 1 Revised 1/14/03
ATLANTIC BEACH BUILDING DEPT.
DEMOLITION — PROPERTY OWNER
RELEASE FORM
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Date:
To Whom It May Concern:
I /We the current property owners of: Lot Pr..y-
Block ��
Legal Description of Property
AICA 7o Fla Lr s Avc Ar,- 3,p C< have contracted with to have
(Address of Property)
�L� �ECy4-L%,,,L CO. to remove the '%--ta L.'�O-oV4u.,
(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.
Signature
N��l
Signature
THIS SPACE FOR RECORDER'S USE ONLY
OWNER
....r.�.....e.,.� n^A^
,1Y x: DON==BUSSEYSigned: G'r vrla Date:..: MY COMMI24 Before me this� day of Ce ( 7Adin the County of Du al,State
EXPIREBonded Thru Nra Of Florida,has personally appeared p i c Gp hp 41 -V71 q f:�1
Notary Public at Large,State of Flori a,County of Duval.
My commission expires: Mawc h 3O , �yq
Personally Known: 41 or
Produced Identification:. r D L Jr. S 6 9-]