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1075 Seminole Rd 2014 Demo = ` f CITY OF ATLANTIC BEACH r s) 800 SEMINOLE ROAD !J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 DEMOLITION PERMIT MI-16-T CULL BYLRM FOR NEXT DAY TNcaFrrrnN- 747-5814 JOB INFORMATION: Job ID: 14-DEMO-154 Job Type: DEMOLITION Description: DEMO SINGLE FAMILY HOME Estimated Value: Issue Date: 10/8/2014 Expiration Date: 4/6/2015 PROPERTY ADDRESS: Address: 1075 SEMINOLE RD RE Number: 170094-0000 PROPERTY OWNER: Name: HITE, JEFFREY A Address: 1075 SEMINOLE RD GENERAL CONTRACTOR INFORMATION: Name: BOSCO BUILDING CONTRACTORS Address: Phone: - - PERMIT INFORMATION: PUBLIC WORKS: Roll off container company must be on City approved list and container cannot be placed on City Right-of-Way. (Approved: Advanced Disposal, Realco, Republic Services, Shappelle's and Waste Management.) Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of construction. FEES: Demolition Fee $100.00 Total Payments: $100.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. City of Atlantic Be, APPLICATION NUMBER Building Departme. (To be assigned by the Building Department.) 800 Seminole Road PRECEIVED (� J Atlantic Beach, Florida : 3-5445 I 1 ' piaw_ Phone(904)247-5826 A(904) 47-58®CT 0 7 2014 r Lol;l�r City web-site: http:Hww\, ,ab.us Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: S�r� Department review required Yes No fZ�� -^ Building Applicant: ` w Planning &Zoning e Administrator Project: Public Wor Public Utilities Public Safety Fire Services Review fee $ F Dept Signature CONTRACTOR EMAIL A )DRESS CONTRACTOR CONTACG 1" # APPLICATION STATUS Reviewing Department First Review: 154Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING WX �u Reviewed by: Date: ? TREE ADMIN. Second Re% []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 09252014 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH D 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 OCT 07 201 Job Address: 1075 Seminole Rd Atlantic Beach FL 32233 Permit Nu Legal Description 5-69 16-2S-29E Parcel # Floor Area of SS q.F t. Sq.Ft Valuation of Work $ Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move <&ZolEDpool/spa window/door Use of existing/proposed structure(s)(circle one):. Commercial identiko �/ If an existing structure,is a fire sprinkler system installed? (Circle one): es `/ Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed: Home Demolition Property Owner Information: Name: Lindley Tolbert Design,Inc Address: 465 Beach Ave City Atlantic Beach State: FL Zip: 32233 Phone 40" '4 yj - qO 2-✓ E-Mail or Fax#(Optional) Contractor Information: Company Name: Bosco Building Contractors,Inc Qualifying Agent: Todd Bosco Address:2158 Mayport Rd City Atlantic Beach State FL Zip 32233 Office Phone 904-241-0320 Job Site/Contact Number 904-241-0320 Fax#_904-241-0326 State Certification/Registration# CBC 1250212 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. /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 tf work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a pmol of six t6)months at any lime af[er work is commenced. /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 YOUR NOTICE OF COMMENCEMENT. /here b certify that/have read and mined this lication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied ith h ther s c e herein or not. The granting of a permit does not presume to give authority to folate or cancel the provisions of any other federal, tat or oc l w e tin traction or the performance of construction. Signature of Owner Signature of Contractor PrintName �.. ................................... Print Name �... ...13d ......................................................................... Sworn to and subscribed before me Sworn to and subscribed before me this Day of cJc—tom' . 20/1-L this e; Day of o--,46 — =1 IAM L POPE 20/y Notary Public.State of Florida WILLIAM L.POPE ✓ Q".. n rV, F tlrt 19 2095 Notary Public Notary u ic,State o F orida Notary Public �— Co�t��,;;,�; �,;,,EE 128745 My Comm.Expires Oct.19,2095 Commission No.EE 128745 Revised 01.26.10 ATLANTIC BEACH BUILDING DEPT. DEMOLITION — PROPERTY OWNER RELEASE FORM Date: To Whom It May Concern: I / We the current property owners of: Lot Block 1 (S--O / -A E Legal Description of Property 03i01 A4r AKA have contracted with c,tYo�have // (Address of Property) Lc) fic-i,��► 4- a,4rLt^Zto remove the ,' C (Company Name) (Sin§k Family,Duplex.Commercial,etc.) Prior to the construction of 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. Erosion control devices will be put in place and will remain in place until grass has cove ed aftcted area or w structure is completed and landscaping is in pl ce. Signatu Signature THIS SPACE FOR RECORDER'S USE ONLY OWNER N/,4/ `"', lle Signed: Date: Before me this y o - ZD/ in the County of Duval,State Wiublic, L.PUPS Of Florida,has personally appeared GlA)d4C y 7bG13E&T hi�tn�PUbIIC,State of Florida Notary Public at Large,State of Florida,Co my of Duval. ':Kpires Oct 19,2015 My commission expires: /0— No EF 128745 <RuSonal�Knawr+—� _or Produced Identification: NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio No. State of FLORIDA County of DUVAL To whom It may concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes, the following Information Is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: 5-69 16-25-29E (03101 Atlantic Beach) Address of property being improved: 1075 Seminole Rd - Atlantic Beach FL 32233 General description of improvements: Home Demolition Owner Lindley Tolbert Design, Inc Address 465 Beach Ave Atlantic Beach, FL 32233 Owner's interest in site of the improvement General Fee Simple Titleholder (if other than owner) Name Address ontractor Bosco Building Contractors, Inc Address 2156 Mayport Rd Atlantic Beach, FL 32233 Phone No. 904-241-0320 Fax No. 904-241-0326 Surety (if any) Address Amount of bond $ Phone No. Fax No. Name and address of any person making a loan for the construction of the improvements. Name Address Phone No. Fax No. Name of person within the State of Florida, other than himself. designated by owner upon whom notices or other documents may be served: Name Address Phone No. Fax No. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06 (2) (b), Florida Statutes. (Fill in at Owner's option). Name Address Phone No. Fax No. - --- ____..,.n, r,frro rrinlinn unless a