Permit Demo SFD 1810 Park St 2012 CITY OF ATLANTIC BEACH
)1 800 SEMINOLE ROAD
' � , --4'1' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000141 Date 2/03/12
Property Address 1810 PARK ST
Application type description DEMOLITION
Property Zoning TO BE UPDATED
Application valuation . . . 500
Application desc
DEMOLISH SINGLE FAMILY DWELLING
Owner Contractor
DUTTON ISLAND LLC ELITE BUILDING CONTRACTOR
645 MAYPORT RD SUITE 5 55 FORESTAL CIR
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 247 -5561
Permit DEMOLITION PERMIT
Additional desc . DOUBLE FEE
Permit Fee . . . 200.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 8/01/12
Special Notes and Comments
DEMOLISHED HOUSE PRIOR TO PERMIT
Other Fees STATE DCA SURCHARGE 3.00
STATE DBPR SURCHARGE 3.00
Fee summary Charged Paid Credited Due
Permit Fee Total 200.00 200.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 6.00 6.00 .00 .00
Grand Total 206.00 206.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
1
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: IS 1 I) ?a-. 5 i `'' l (
� Permit Number: �'
Legal Description ,25 - 6e /7-15 -o?q E Parcel # / 7,2,2 4 i • 0000
o v Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ SOOO . Proposed Work heated /cooled $( (p non heated /cooled .25A
Class of Work (circle one): New Addition Alteration Repair Move Demolitio pool /spa window /door
Use of existing /proposed structure(s) (circle one): Commercial : esident'Ti
If an existing structure, is a fire sprinkler system installed? (Circle one): • es `. N /A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: s,o ( *�� ,� a �Z � horns_ Jl �
0 dP.6%s 004 levcl: tea- o - 1 le .
Property Owner Information:
Name: Z .K64-2. Address: . (11. _ 0 City O\rkvykic,. State Fl Zip A2.1 2,3 Phone '?04 • A - 5 2,3
E -Mail or Fax # (Optional) goy g63 Gc) A ( 1 y
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Contractor Information:
Company Name: �j1!}e. ti A ( . .e Qualifying Agent: ?C l eCl/C-�le�C,6
Address: City (A., `2eec ti,,.� State T1 Zip 3
Office Pho y 5 -� . -,r"a � �` �e-- � _ k ?l
o b Site / Contact Number (s' c t 13 Fax# L • S 3C,
State Certification/Registration # C,`?jC. (k..4 - C, (
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, 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 of six (6) months at any time after
work is commenced . I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, F urnaces, 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.
1 herebv certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
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type of work will be complied with whether specified herein or not. The grant of a perm does not presume to give authority to violate or cancel the
provisions of any other federal. state, or local law regulating construction or the performance of construction.
Signature of Owner _ � ,c/ -� s Signature of Contractor i
Print Name —" 2 .
..... .... � Print Name sik.c.v4aus_4\ �C.\,„e..0sh,51'it-
S
worn tg and subscribe before me Sworn to and subscribed before me
this an^ Day of , 20 fa., this 3� Day of cejli.u,z„ r—\ , COMMISSION t DD 915979 2012
O. __�_ / ' � , _ % - _ -_ - -
Notary" ublic �; ' ub - �r_Tn 11 _ -
2o t.a v P � O1IAR. P'`% c '� ,� ;
. r• ISSION t EE 064342
MY COMMISSION z T oN
EXPIRES: June 14, 2015
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- - ; B ondedtxaanrP u.a.r+ t.R evised 01 .26.10
'�I) .. EXPIRES: December 12, 2013 ,_ 1 _ - ...... ,F � ,� e Banded Thin Budget Nobly Se ices
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'-art Compliance Investigation Form
Investigation # Date of Request: /' 3 " ' Time of Request:
Name of Person Making Request:
Address: Phone #
Investigation Type:
At se 7exeoe... 5 Atcb ivo • r
lS opt/ �u<
Location (Address) of Violation:
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Phone Number: Property Owner/Manager:
Request Taken by: Investigator: ` -,1;2 2 ` /2
Action Taken: P, S le 1 S /or 4/0 k. G rp � S ) : ie
Prop-or 17 h 0 rr
Compliance:
Legal Description: RE #:
F: \Code Enforcement \Compliance Investigation Form.doc Oct 9 2009