Permit Demolition 1322 Ocean Blvd 2012 CITY
OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000866 Date 7/11/12
Property Address . . . . . . 1322 OCEAN BLVD
Application type description DEMOLITION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
DEMO SINGLE FAMILY HOME
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Owner Contractor
------------------------ ------------------------
HENDERSON, ROBERT JAX DIRTWORKS INC
159 11TH STREET 13553 ATLANTIC BLVD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225
(904) 237-2824
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Permit . . . . . . DEMOLITION PERMIT
Additional desc . .
Permit Fee . . . . 100 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 1/07/13
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Special Notes and Comments
Contact Public Works (247-5834) for Erosion and Sediment
Control Inspection prior to start of construction.
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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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 �S
Job Address: 132 l) n &w- Permit N ber: U 20�Z
Legal Description Parcel#
Floor Area of Sq.Ft t
onon-heated/co
of Work S Proposed Work heated/coolede
Class of Work(circle one): New Addition Alteration Repair Move L)emolitio pool/spa window/door
Use of existing/proosed structures)(circle one): Commercial est ent�
If an existing structure,is a fire sprinkler system installed? (Circle one): es No N/A
Florida Product Approval #
For multiple products use product approve orm
Describe in detail the type of work to be performed: r
Property Owner Information:
Name: 0 n Address:
City State Zip3=53 Phone Qq
E-Mail or Fax# (Optional) _ Zc/7_
--- —7.Z
Contractor Information:
Company Name: Qualify Agent:
Address: cityStati in
Office Phone Job Site/Contact Number Fax#
069
State Certificatio egistration#
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 certt�t o k or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of al!laws regulatingggggg������ot�{/ut uct n in s 'urisdiction. T/zis permit becomes mill
and void if work is not commenced within six(6)months, or if construction or work is suspended or ab tforo of siz 16)months at anv time after
work is commenced. I understand that separate permits must be secured for Blectricat Work, Plumbing,��ggnsB113, f urnaces, Boilers, Heaters,
Tanks and Air Conditioners,etc
WARNING TO OWNER: YOUR FAILURE TO RECORD A NONCE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTENT) TO OBTAIN FINANCING, CONSULT WITTY
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
1 hereb 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
type ofYwork will be complied with Nrs d e,e or not. The granting of a permit does not presume to ve authority to violate or ancel the
provisions of any other federal,stat gu construction or the performance ofconstruction.Signature of OwnerSignature of Contractor
Print Name p. �� �...... Print Name
................. ►tb ,pne/
# . .. a.Sworla ti and subscribed bef r i Swar a�nd ;Ascribedl
thi Day of t 20 �" thi o 20
IR L.G HAM
F'
Notary Public ,,,�v pEgpRAN ': :
a+� MY COMMISSION#EE 057349 Fe uary 14,zoic
eXPIRES'May 21,2015 Bonded Thru Ndt# ublie Undo
Revised 01.26.10
Bonded
Thnt Notary Public Underwriters
ATLANTIC BEACH BUILDING DEPT.
DEMOLITION — PROPERTY OWNER
' RELEASE FORM
F113
Date:
To Whom It May Concern:
I/We the current property owners of. Lot
Block s 7
Legal Description of Property.
Alta X322 66L)4'() 46W
(Address of Property) have contracted with to have
A- to remove the
(Company Na ) (Single Fami Duplex,Commercial,etc.)
Prior to the const,uction of: 0
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
Signatu e
THIS SPACE FOR RECORDER'S USE ONLY
OWNER
Signed: Date: l2
Before me this da of d/ in the-Countj of Duval,State
—•�!±"'=—'—�-1 Of Florida,has personally appeared y.�..
'DEgpppl{—AMANDA WHITE
� Notary Public at Large,State of Florida,County of Duval.
?� ?= M,=
Y COMMISSION#EE 057949 My commission expires:
EXPIRES:May 21,2015
' ��rnN�rypubkUnderw,1ers Personally Known:
,• Produced Identification:
�l�rP1�,E Y
47-1-,41v7-1c
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Cocrr�y� /t/o r-i�.a • .
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I/ t i I\
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er.KA
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A/rr.� r Po.tieb 'v �
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City of Atlantic Beach
Complete Plans Checklist
Provide (2) copies of signed and sealed Architectural/Engineering Plans to include five (5)
sets of Site Plans including Site Management and Erosion Control Plans. (Note: Commercial
projects will need (3)sets of signed and sealed plans; one to be sent to Fire Department for review.)
O Cover Page:
o Address of project
o Occupancy Class: For One &Two family"Group R-Y.
o Applicable codes; 2010 Florida Building Code, 2010 National Electrical Code, 2010 Florida Fire Prevention Code
and COAB Code of Ordinances. Energy forms as required by Florida Energy Code.
o Index of all drawings & attachments and all pages numbered.
o Printed name, contact info, date and signature of person responsible for the design of the structure.
❑ Site Plan (Legal Survey):
o Distance of proposed house to property lines
o A/C compressors, generators, LP gas tanks, pool equipment etc.
o Driveways, walkways, patios...
o Impervious Surface Area (lot coverage) calculations—tabulation of all impervious areas required
o Drainage plan with supporting on-site water storage calculations, and location of easements.
Contact Public Works for information on On-Site Storage requirements for added impervious surface area.
Erosion & Sediment Control Plans (Can be included on Site Plan/Survey):
• Silt fence location, construction detail and maintenance plan.
• Installation must be inspected and approved by Public Works before any site work is started.
o Inlet protection (if existing storm water inlets are adjacent to property.
❑ Construction Site Management Plan (Can be included on Site Plan/Survey):
o Location of any proposed demolition
o Grading &drainage surface water management plan
o Onsite &offsite parking for construction workers
o Location of temporary fencing with height and screening indicated
o Location of(Atl. Beach franchise approved) dumpster. Location of construction trailer&chemical toilet.
COAB Code of Ordinances—Sec.6-18
❑ Foundation Plan:
o Required plan note i.e.: "A foundation survey shall be performed and a copy of the survey shall be on the site for
the building inspector's use prior to framing inspection." Or, "all property markers shall be exposed and a string
stretched from marker to marker to verify required setbacks."
❑ Floor Plan:
o Size and arrangement of all rooms and intended use.
o Locate air handlers, fireplaces, water heaters, attic access, etc.
o Label accessible 1St floor bathroom, egress, windows etc.
❑ Elevations
❑ Structural Engineering:
o Structural design criteria, loading requirements indicated.
o Shear Wall plan.
o Size all beams, headers and support requirements.
o Detail uplift& load path connections.
o Engineers embossed seal required.
o Supporting structural calculations included.
'10 FBC-Sec.1603
❑ Roof Plan:
o Indicate how attic is to be ventilated.
1
O Sections and Details:
o Typical wall sections for each dissimilar wall type.
o Stair sections with guard and handrail details.
o Balcony guardrail details.
O Electrical Plan:
o Riser diagram including size and type of service entrance conductors
o Location of all receptacles, switches and the distribution panel.
o Required plan note: "All electrical wiring to be in accordance with '10 NEC. Provide arc-fault circuit interrupters in
all bedrooms per article 210-12."
O Plumbing (please note if the following applies):
o New or existing private well on property
o Irrigation to be installed
o Irrigation meter desired
2
THIS INSTRUMENT PREPARED BY:
Richard T.Morehead Title&Escrow,Inc.
Beth Murphy
444 Third Street
Neptune Beach,FL 32266
RECORD AND RETURN TO:
Richard T.Morehead Title&Escrow,Inc.
444 Third Street
Neptune Beach,FL 32266
RE PARCEL ID#: 171846-0000
CONTRACT SALES PRICE: $339,000.00
WARRANTY DEED
THIS WARRANTY DEED made this 20th day of June, 2012 by Susan Gay Hess, a
single person and Derek A. Hess, a married person and S. Paul Hess, a married person and
Larry E. Hess, a married person, all conveying non-homestead property, hereinafter referred
to as Grantor, whether one or more, and whose address is 10897 Krugerrand Lane,
Jacksonville, Florida 32218, to Robert Henderson, hereinafter referred to as Grantee, whether
one o L ore, and whose address is_L P? 1�� �-t'
(Wherever used herein the term"grantor"and"grantee"include all the parties to this instrument and the heirs,
legal representatives and assigns of individuals,and the successors and assigns of corporations.)
WITNESSETH:
THAT Grantor, for and in consideration of the sum of Ten and NO/100 Dollars and other
valuable considerations, in hand paid by Grantee, the receipt whereof is hereby acknowledged,
hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms unto Grantee the
following described land situate, lying and being in the County of Duval, State of Florida to wit:
Lot 1, Block 54, MANDALAY, a subdivision according to the plat thereof
recorded at Plat Book 10, Page 11, in the Public Records of Duval County,
Florida.
SUBJECT TO taxes accruing subsequent to December 31,2011.
SUBJECT TO covenants, restrictions and easements of record, if any; however, this
reference shall not operate to reimpose same.
TO HAVE AND TO HOLD the same in fee simple forever.
AND Grantor hereby covenants with Grantee that Grantor is lawfully seized of said land
in fee simple; that Grantor has good right and lawful authority to sell and convey said land; that
Grantor hereby fully warrants the title to said land and will defend the same against the lawful
claims of all persons whomsoever; and that said land is free of all encumbrances.
Page 1 of 2 Form software by:Automated Real Estate Services,Inc.-800.330.1295 File: 1213996EM
IN WITNESS WHEREOF, Grantor has signed and sealed these presents the day and
year first above written.
Signed, se d and delivered in our presence:
j\
1J
ess Susan Gay Hess
fitn
M
Witness
De -A.Hess
S.Paul Hess
$By: Larry E.Hess,as Attorney-in-Fact
Larry E.Hess
STATE OF Florida
COUNTY OF Duval
The foregoing instrument was acknowledged before me this 20th day of June, 2012 by Susan
Gay Hess and Derek A. Hess and Larry E. Hess, individually and as Attorney-in-Fact for S. Paul
Hess. He/ ey ve produced_ j)(2.111 LA-r S L-I C-F�S E, as identification.
N Public,County and Sta oresaid ro��g ��17ABFTh,
Notary Printed Signature ; �ovemb 2Dyt
My commission expires: ,r
"U
Documentary Stamps in the amount of$2,373.00 have been paid. Ili,;11/7g1,F 10P\o����
Page 2 of 2 Form software by:Automated Real Estate Services,Inc.-800.330.1295 File: 1213996EM
s CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
I ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
OWNER ASBESTOS NOTIFICATION STATEMENT
7 1 Date: Z
I1 Ir
i
Building Permit#
Site Address: f ZZ 4Gev► P��/d iJ7�G/7T�� �GtG 3 2;3.3
Street City State Zip
I
t �
104.4.4 Asbestos removal. Moving, removal or disposal of asbestos-containing materials on a residential
building where the owner occupies the building, the building is not for sale or lease, and the work is performed
i according to the owner-builder limitations provided in this paragraph. To qualify for exemption under this
paragraph, an owner must personally appear and sign the building permit application. The permitting
! agency shall provide the person with a disclosure statement in substantially the following form:
i E
Disclosure Statement
State law requires asbestos abatement to be done by licensed contractors. You have applied for a permit
under an exemption to that law. The exemption allows you, as the owner of your property, to act as
your own asbestos abatement contractor even though you do not have a license.You must supervise
the construction yourself. You may move, remove or dispose of asbestos-containing materials on a ,
residential building where you occupy the building and the building is not for sale or lease, or the
f building is a farm outbuilding on your property. If you sell or lease such building within 1 year after the
asbestos abatement is complete, the law will presume that you intended to sell or lease the property at
j1 the time the work was done, which is a violation of this exemption. You may not hire an unlicensed !
person as youpe7ritractor. Your work must be done according to all local, state and federal laws and
regulations iA apply to as estos abatement projects.It is your responsibility to make sure that people
employe y u e . en a uired by state law and by county or municipal licensing ordinances.
rop Owner's ignature
Subscri§pd and sworn to before me this 2 day of ,�D/Z—, rsonally appeared
i
��,50 who is personal y own to me or
s produced as identification, and who did/did not
take an oath.
k �1� 1
�..y. pEBpF{Ai{AMANDAWHVTE
Notary Public Signature Seal iS810N I EE 057349 E
*' MY COMM
hRN2015
oyPbcUndery
rtiters
g Tru
• P,f fi
FORM DATE 10.01.2006 FORM: ASBOWN
s� City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building 800 Seminole Road 9 Department.)
Atlantic Beach, Florida 32233-5445 .z – 1��
Phone(904)247-5826 - Fax(904)247-5845
rf E-mail: building-dept@coab.us Date routed:
City web-site: hftp:llwww.coab.us
APPLICATION REVIEW AND TRACKING FORMA
Property Addres JJZ z d ebtAl 34 1/,6 Department review re uired Yes No
p Building
Applicant: .,U'�T' WUdj 5 Planning &Zoning
Tree Administrator
Project: ,� /� ublic Works
Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District Ir
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: 06roved. ❑Denied.
(Circle one.) Comments:
BUILDING O._.- �� 1 '4' ��"' �-�( �.��'v - Co., )'Y.�
PLANNING&ZONINGn�'f0— �) 1 y' S�3 y
4 Reviewed by: Date: 7z// /Z
TREE ADMIN. Second Review:
[]Approved as revised. []Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27110