178 Beach Ave interior demo 2013 CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002783 Date 6/03/13
Property Address . . . . . . 178 BEACH AVE
Application type description DEMOLITION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
interior demo
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Owner Contractor
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178 BEACH AVE LLC CANTRELL CONSTRUCTION, INC
6 BAY ST E SUITE 500 1015 ATLANTIC BLVD
JACKSONVILLE FL 32202 ATLANTIC BEACH FL 32233
(904) 545-1428
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Permit DEMOLITION PERMIT
Additional desc . .
Permit Fee . . . . 100 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 11/30/13
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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
Job Address: Off 0 ���� A V� Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. Sq.H
Valuation of Work $ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pooUspa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
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: jYm d _ /G lelolp _
Property Owner Information:
Name: 1'i% lear l A*,u,*, W_ Address:
City 1c .w416 State aZip 3126? Pho e 90 -6??- 73
E-Mail or Fax#(Optional) td C 6 1 aw. C. 4^
Contractor Information:
Company Name: Quali i A ent: � u-
Address: O 5 City^ a G L� State�_Zip 3Z2
Office Phone fAJob Site/Contact Number Fax#
State Certification/Registration# r^ 4 Dlo2 S' /y
Architect Name&Phone# 13 I rt
Engineer's Name&Phone# N 4
Fee Simple Title Holder Name and Address of A
Bonding Company Name and Address 1410111,-
Mortgage
41kMortgage Lender Name and Address t�
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 rf 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, Wells, Pools, Furnaces, Boilers, 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 YOU]i NOTICE OF
COMMENCEMENT.
1 hereby 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 o1 work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,sjgte, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor '
Print Name Print NameM�.. C LI/
Sworn to and subscribed before me SworQo and sub I efor me
this "Y)ay of 20 I thi of 20
Notary Pub is No u
L
01.26.10
dRABRANDON L TRAUB MY COMMISSION#OD 957780
MYCOMMISSION#DD 974046 -' EXPIRES:February 14,2014
EXPIRES:April 18,2014 h BondedThraNotary PuhlicUnderw#m
1 A(h Bonded Thru Notary Public Undwwriters