315 11TH ST INTERIOR DEMO i r ✓Jj'.
CITY OF ATLANTIC BEACH
.,s
j 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
DEMOLITION PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMATION:
Job ID: 15-DEMO-264
Job Type: DEMOLITION
Description: INTERIOR DEMO
Estimated Value: $500.00
Issue Date: 2/4/2015
Expiration Date: 8/3/2015
PROPERTY ADDRESS:
Address: 315 11TH ST
RE Number: 170099-0000
PROPERTY OWNER:
Name: BURBRIDGE, DAVID & SHANNON,
Address: 315 11TH ST
GENERAL CONTRACTOR INFORMATION:
Name: HOMEOWNER BLDG SVCS, INC (RC)
Address: 739 E BROOKMONT AVE QA ALEXANDER, GLENN
RICHMOND
Phone: - -
PERMIT INFORMATION:
FEES:
STATE DCA SURCHARGE $2.00
Demolition Fee $100.00
STATE DBPR SURCHARGE $2.00
Total Payments: $104.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address: 315 111h Street Permit Number:
Legal Description Lot 4& %Of Lot 6 Block 14 Parcel
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 500 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/pro osed 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: Removal of walls 7 e.x-c9jL-,r OC—
Property Owner Information:
Name: James& Sharisse Vergara
City Atlantic Beach
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Homeowner Building Services,Inc.
Address: 739 Brookmont Ave. E. City Jacksonville State Fl Zip 32211
Office Phone 904-322- 1054 Job Site/Contact Number Fax#
State Certification/Registration# CRCo5894 . CCC 1324821
Architect Name&Phone# Vermey Architect 904-246-1150
Engineer's Name&Phone# Verney Architect
Fee Simple Title Holder Name N/A
Bonding Company Name and Address N/A
Mortgage Lender Name and Address_ N/A
Application is hereby made to obtain a permit to do the work and installations as indicated. I 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 if 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 per
must be secured for Electrical Work, Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters,
Tanks and Air Conditioners,etG
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.
I 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 of 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,state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name ,� � Print Name
� a
.),%YWyk Notary Public State of Florida
Sworn o and subscribed e re me Swo nam
t o FF 0869
this�Day of W*FbMORT a t ' Day a Y 20
CommissiorW FF 180935
Notary Public Notary Public