341 Sargo Rd 2013 interior demo CITY OF ATLANTIC BEACH ,
1s) 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003836 Date 12/18/13
Property Address . . . . . . 341 SARGO RD
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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FORE, STUART ASHBY HOMEOWNER BLDG SVCS, INC (RC)
1616 BEACH AVE 739 BROOKMONT AVE E
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211
(904) 322-1054
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Permit DEMOLITION PERMIT
Additional desc . • Plan Check Fee . 00
Permit Fee . . . . 100 . 00 0
Issue Date Valuation
Expiration Date . . 6/16/14
-----------
-----------------------------------------
2 . 00
Other Fees . . . . . . . . . STATE DCA SURCHARGE
STATE DBPR SURCHARGE 2 . 00
_ ________ ----
Fee summary Charged
Paid Credited ----Due---
_ _ ------ --
---------- ----------
- . 00
Permit Fee Total 100 . 00 100 . 0000 00 . 00
Plan Check Total • 00 . 00
Other Fee Total 4 . 00 4 . 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: .3 44 1 � Permit Number:
Legal DescriptionParcel#
1211011, ea o q. t. Sq-Ft
Valuation of Work$_115a d Proposed Work heated/cooled_ non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa 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 pro uct ap In
Describe in detail the type of work to p rfo d: t t OAJ T
0
Property Owner information: ti
Name: fie_ Address:1!�1 b �4cfw
City et' Stat eC{-Zi Phone
E-Mail or Fax#(Optional)
Contractor Information:
m
/��/���� uali i A gent:
Company Name: t I�JW e±&�J'� +/�S �Ft y_t 5 Q f '� g State t G• Zip
Address: /+rant— City JfbY
Office Phone a r_ — - Job Site/Contact NumberFax#
State Certification/Registration# c Z
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
t to do the hat no work or
llation has commenced
issuance the
licti ons permit
and hato t allrainworwill mibe performed toomee rk he standards fall as laws regulatinicated. I g ruction In thiis jjurisdictio . his permit bectime omesrior onull
and work void
mmeneed.of Icommence understand tihat sepa'thin six rate permits months,
if
be secutred for Electrics!Work,Plumbing,Sigion or work is suspended or ns,or aWells,Poeriod ols,XI urnaces,Boilers
work
months ai
Heaters,
Tanks and Air Conditioners,etc-
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOTO OBTAIN FINANCING, CONSPAYING TWICE FOR T MENTS VV TH
TO YOUR PROPERTY. IF YOU INTEND
YOUR LENDER OR AN ATTORNEY
BEFORE
REORDING YOUR NOTICE OF
COMMENCEMENT.
I here ab�Yw ert y t hat c�ph'ed an whethned this.
ledliherein o not.o The grantiw the same ng of to permitrue and doescnot p>provisionst. All umeto gi l autho ty toaws and inv o ategor cancel this
tvP j pp 7
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contract
- Print Name x�✓.......,fz.:...._�`iC.Z'v�,cJ1�..�-.:....................
Print Name __S7.11 f112.7........ C.... .. ....
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............. .........J.........._.
Swod subsc i le �efore me // Swo nd s b rib o e 20
this�Y of 2015 hi ',,,-a. , . 11
H GRAH
60
Notary Publ' °�� DIE o ub yn,aryut els
t�NDEZ "P"b�pose rs evised 01.26.10
My C0MM'1"%fbN#X148600
EXPIRES:Novena{ �7,2015
F
FL Notary .q%.66 A..�Co�.�
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