Permit Int. Demo 368 7th St 2011 cr , CITY OF ATLANTIC BEACH
4 s l 800 SEMINOLE ROAD
v ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
H
"N )13 s
Application Number 11- 00003026 Date 12/20/11
Property Address 368 7TH ST
Application type description DEMOLITION
Property Zoning TO BE UPDATED
Application valuation . . . 500
Application desc
interior demo
Owner Contractor
TOLBERT GENESIS BUILDING CORP
368 7TH STREET 2158 MAYPORT RD.
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 241 -0320
Permit DEMOLITION PERMIT
Additional desc .
Permit Fee . . . 100.00 Plan Check Fee .00
Issue Date Valuation . . . . 0
Expiration Date . . 6/17/12
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
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: b 7 5 Permit Number:
Legal Description 5 -6 / 6 -. --a9 tiiL C Parcel #
Floor Area of Sq t Sq.Ft
Valuation of Work $t Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Addition Alteration Repair Move Dlitibn pool /spa window /door
Use of existing/proposed structure(s) (circle one): Commercial
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: .t,--.0(, . ( . or∎
Property Owner Information: /�1 �/�, /
Name:f�`c/ '3/! r-/ a2 7 r Address: IC / 0.-0 jC , 4r"�� L / &A
City A t'� Z a,2 State�L.Zip 3:2,233 Phone .y /- k"7 5'7
E -Mail or Fax # (Optional)
Contractor Information:
b.1�
Company Name: " 3 r IR dl(Q IN 9 Carezik-ToeS Qualifying Agent: 'I MD A 'GCSCO
Address: at W i Scs_VALI L A d City State p( Zip 3 33
Office Phone7 ,2 6 j) Job Site/ Contact Number 55e/ 09 0 4' Fax # '3 y ,.2 VI r ) 3� t
State Certification/Registration # CA-125
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
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 laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a _period of six (6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, W ells, Pools, Furnaces, Bo Heaters,
Tanks and Air Conditioners, etc.
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.
I hereby 0, / haver. ad . nd • ami this a,plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will .e coma i ed w het • - erein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any ther fe, eral, st.� • or 1. ! . c regulating construction or the performance of construction. ,,
Signature of Ow er _ Signature of Contrac ■
Print Name • .y �) 4 Print Name — Todd 4 - i .. C
Sworn to and subscribed before me Sworn to and subsc bed before me
this 2.c5 Day of QocoN ->- ,20/( this 9D Day of i)Qc.:P,L ? .- , 20/ 1
h.�a vin WILLIAM L. POPE ` / / � 4M IAM L. Pl1PE
Notary Public Nota Public, State of Flori otary Pub�lic M 15otary Public, State of Ronda
My Comm. Expires Oct. 19,2015 kILCo ' i si 19,2015
Commission No. EE 128745 s h o. 128745
DO NOT WRITE BELOW - OFFICE USE ONLY
Applicable Codes: 2007 Florida Building Code w/ 2009 Revisions
Review Result (circle one):
Approved Disapproved Approved w/ Conditions
Review Initials /Date:
Development Size
Habitable Space Non- Habitable
Impervious area
Miscellaneous Information
Occupancy Group
Type of Construction
Number of Stories
Zoning District
Max. Occupancy Load
Fire Sprinklers Required
Flood Zone
Conditions /Comments:
s t 800 Seminole Road
C. %? Atlantic Beach, Florida 32233
i s 1
Telephone (904) 247 -5800
75 —5
°r FAX (904) 247 -5805
Construction Site Management Plan Compliance
A construction site management plan conforming to Atlantic Beach City Code Sec 6 -18
has been approved as a part of this building permit. The Construction site management
plan was approved based upon the following information.
1. Parking plan - parking plan showing how site will be accessed and all onsite
and abutting street parking areas.
2. Location of construction trailers, loading /unloading area and material storage
area.
3. Location of chemical toilet area - chemical toilets must be kept out of City
right -of -way and not further than 15 feet from structure under construction.
4. Location of dumpster - dumpster must be from approved waste company (in
accordance with Chapter 16 City Code). As of 2009, approved dumpster
companies for Atl. Beach are Advanced Disposal, Realco Recycling, and
Shappells. Dumpsters are to have tarp covers or rigid covers on windy days.
Dumpsters must be removed prior to issuance of Certificate of Occupancy or
Completion.
5. Traffic control plan, showing access with dimensions, area to be stabilized,
narrative on phasing of construction with adequate parking and delivery of
materials.
6. Site cleanliness. Contractor must have the entire construction site cleaned by
Friday of each week. This means removal of scrap lumber, concrete remnants
and other such construction debris including cans, metal, plastic and paper.
7. Erosion and Sediment Control. Contractor must maintain all elements of the
approved Erosion & Sediment Control Plan (silt fence, catch basin filters, etc.)
until sod or other stabilization has been placed and approved by Public Works.
8. Other activities, where special conditions are identified by the Building
Official.
Failure to comply with the Construction Site Management
Ordinance may result in a Stop Work Order being issued in
accordance with City Code Sec. 6 -17 (3)
Revised 6/2009
Permit Number Tax Folio Number
NOTICE OF COMMENCEMENT
STATE OF FLORIDA
COUNTY OF DUVAL
THE UNDERSIGNED hereby gives notice that improvement will be mad to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information is
provided in this Notice of Commencement.
1. Description of property: J or STi�? /"
A (09 / �C'-r7. J a- /� !y'� �► 1.
2. General description of improvement: 01 Q J it
M .1A
3. Owner information:
1. Name and Address: `. , - 3/ _ , wZ i4-6
2. interest in property: ot,,,, r
3. Name and address of fee simple titleholder (other than owner): p
✓
4. Contactor's name and address: (7e4eSis 6/ 1,) Al- Aar ( rims -2 (S'V. N1a�{ (�}�
a. Phone number: "be/ / 2.5// n I' 0. ��
b. Fax number: l Gb'1 2 ' / 0 ( V'A' ,
5. Surety Information:
a. Name and address:
b. Phone Number:
c. Fax Number:
d. Amount of Bond:
6. Lender's name and address:
a. Name and address:
b. Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other
documents maybe served as provided by 713.12(1)(a), Florida Statutes.
a. Name and address:
b. Phone number:
c. Fax number:
8. In addition to himself/herself, owner designates of
to receive a copy of the Lienor's Notice as provided in
Section 713.12(1)(b), Florida Statutes.
9. Expiration date . f otic o. • m • nce • e (the expiration date is one (1) year from the date
of Recording less a • - i j! ec t , t)
Signature of Owner I j'�l
V'h Tar V,
Sworn to and subscribes . ore me this '24. day of _,(4 , 201
Notary: 4111,.... G u '
l wn"'perl_tmally /ID shown:
My commission expires:
WILLIAM L. POPE
Notary Public, State of Florida
My Comm. Expires Oct. 19, 20
Commission No. EE 128745
Doc # 2011273371, OR BK 15802 Page 132.
Number Pages: 1
Recorded 12/20,2011 at 10:14 AM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10 00