Permit Interior Demo 296 Royal Palm Dr 2011 40**' CITY OF ATLANTIC BEACH
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.r 800 SEMINOLE ROAD
W J�V r ATLANTIC BEACH, FL 32233
r INSPECTION PHONE LINE 247 -5814
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Application Number 11- 00002045 Date 5/06/11
Property Address 296 ROYAL PALMS DR
Application type description DEMOLITION (PARTIAL)
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
INTERIOR DEMOLITION ONLY
Owner Contractor
KLOTZ JEFFREY DAVID AR COLLEY CONSTRUCTION INC
P.O. BOX 330833 512 18TH ST N
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 866 -1165
Permit DEMOLITION PERMIT
Additional desc . INTERIOR DEMO ONLY .00
Permit Fee . . . 100.00 Plan Check Fee . .
Issue Date . . . Valuation . . . . 0
Expiration Date . 11/02/11
Special Notes and Comments
THIS PERMIT DOES NOT GUARANTEE APPROVAL
OR ISSUANCE OF THE SUBMITTED PLANS FOR
THE RENOVATIONS, INTERIOR REMODEL OR
SLAB. THIS PERMIT IS FOR INTERIOR
DEMOLITION ONLY
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
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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ATLANTIC BEACH BUILDING DEPT.
,„:11...m:, '�" DEMOLITION — PROPERTY OWNER
r ,.. RELEASE FORM
Date: 05 0 (o 't/
To Whom It May Concern:
•
I / We the current property owners of: Lot /7764 3 — Eacioe
Block 3$— S - .R 2, err
Legal Description of Property
AKA 2/Y0 2W/K. 7440K3 &C.__ have contracted with to have
(Address of Property)
4 ,. ktay .:fl,{/5'T.Z'E gimov, to remove the c —e- - sS
(Company Name) (Single Family, Duplex, Commercial etc.
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Prior to the construction of : w.Q,-r� --m • I i p. - - -
As a condition of issuing the permit we agree to the following:
1. All utilities are to be located and clearly marked.
2. Once house is removed, lot is to be graded and leveled.
3. All construction debris is to be removed from the property.
4. Affected area is to have grass or seed in place.
5. Erosion control devices will be put in place and will remain in place until grass
has covered affected area or new structure is completed and landscaping is in
place.
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Signature 1 1
Si•' aure
THIS SPACE FOR RECORDER'S USE 0 Y
OWNER
Signed: _.42-1 YG10 Date: //O // /
Before me this Ott day of &if eZc 1/ in the County of Duval, State
Of Florida, has personally appeared 1Z7-- /<c LCT - Z—
Notary Public at Large, State of Florid. County of Duval.
My commission expires:
Personally Known: •L F O 7` __ . Afreartoridit
Produced Identification: Gad Testa
`` if My Commission D099900
.,` „ -$ -'xP. es 06/07/2014
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