Permit Int Demo #1 363 Atl 2011 CITY OF ATLANTIC BEACH
c. - 800 SEMINOLE ROAD
--+ - . ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001915 Date 4/15/11
Property Address 363 ATLANTIC BLVD UNIT 01
Application type description DEMOLITION
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
demolish interior
Owner Contractor
URBAN PARTNERS CONSTRUCTION
4320 PABLO PROF CT STE 103
JACKSONVILLE FL 32224
(904) 219 -7579
Permit DEMOLITION PERMIT
Additional desc .
Permit Fee 100.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/12/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 100.00 100.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 104.00 104.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
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CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247 -5845
Sob Address: r � 3 1,�.- 46,,e_ ^
Permit Number: _
.,egal Description Parcel #
Floor Area of Sq.Ft. Sgkt
Taluation of Work $ Proposed Work heated /cooled non- heated/cooled
' . l a s s of Work ( c i r c l e one): New Addition A l t e r a t i o n R e p a i r Moe Demolition pool/spa window /door
Jse of existing/proposed structure(s) (circle one): Commercial Residential
fan existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
lorida Product Approval #
'or multiple products use product approval form
)escribe in detail the type of work to be performed: - -fil ot / /SA rid 77d i-- 0
0 ‘- S 7? c,t 1 /''/6 --E
ronerty Owner Information: / 7 �t.
-ante: Address:
ity State Zip Phone
-Mail. or Fax # (Optional)
ontractor Information / J // ��
ompany Name: f - 4,�.� ' 7 , e--t t il,G, -' (�k,.. , Qualifying Agent: , lJ�t‘.,.i,oa , -- d,.i Z,Qc e'.s
ddress: V230 Apew P2E)te.rs o, c C % City .3"-9,-t- State ,e Zip 2.2 2.Z 9
ffice Phone 704 2 - ( y 1 C 9 Job Site/ Contact Number F #
`ate Certification/Registration # C a C /'&J • _ _
rchitect Name & Phone #
agineer's Name & Phone # war r / /
:,e Simple Title Holder Name and Address
onding Company Name and Address
[ortgage Lender Name and Address
)placation 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
•uance o a permit and that all workwill be pe ormed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
:d void work is not commenced within six (6)�months, or if construction or work is suspended or abandoned for a_ penbd of six j6) months at any time er
irk is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters,
inks and Air Conditioners, eta
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 RECORDING YOUR. NOTICE OF
COMMENCEMENT.
ereby certify that I have read and examined this placation and know th a be true and correct. All provisions o laws : ordinances gover • g this
'e of work will be complied with whether spec d herein or not ._l ie Mito b tr ng of a permit does not presume to • e a d rity to vio • e or - el the
visions of any other federal, state, or local kiwi-:- -. •� ' - • ction or the performance of construction. i
-. / 0
gaature of Owen _ Signature of Contract. /' d /1 1 r
int Name C4lt'ZC ...._),x L.._1. -.n1IY.......1 Q...2._ ... Print Name l'' 4
corn ,,• .nd subscrib d before me Swoi to and subs ib�. before me
s fay of nL , 20 1/ this T ."- Tray of 9 , 20 I L
do . 1 /i .L ,._ ' • r! 'ue ARTHADENISE
4 0 ' u.1icc Notary Pub is #.,,i r' ti - zxm 96r
SUSAN ' T a , * Expires 7/25/2012
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N o t a r y P u b l i c � / . R ,,;,'. 2 6 , Q Notary Awn., Inc
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December 9.20*