130 CLUB DR DEMO `S CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
` INSPECTION PHONE LINE 247-5814
DEMOLITION PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-DEMO-970
Job Type: DEMOLITION
Description: demo home and concrete
Estimated Value: $7,000.00
Issue Date: 5/6/2015
Expiration Date: 11/2/2015
PROPERTY ADDRESS:
Address: 130 CLUB DR
RE Number: 170319-0000
PROPERTY OWNER:
Name: Shields, David
Address: 53 Oceanside DR
GENERAL CONTRACTOR INFORMATION:
Name: ELITE HOMES INC.
Address: 357 12TH ST QA CHRISTOPHER DAVID LAMBERTSN
Phone: - -
PERMIT INFORMATION:
FEES:
Demolition Fee $100.00
STATE DCA SURCHARGE $2.00
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.
City of Atlantic Beach 1�cEwE APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
pPR
' 800 Seminole Road 2 9 2015 >a� a _ 9 70
Atlantic Beach, Florida 32233-544
&,2 //J�
Phone(904) 247-5826 • Fax(90 - 45
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 19A 7�416 Department review required Yes No
Building
Applicant:
EZ4
.�L 3 M�s Planning &Zoning
Tree Administrator
Project: bimi &3nG /fr2) u is or
eon is Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: proved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: �� Date:
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 07/27/10
PUBLIC WORKS PLAN REVIEW COMMENTS
Date: 4— �/ Application Permit#:
Project Name/Address :/ ✓ � r
Check Box to
Application Tracking Comments Select
CORRECTION ITEMS:
CSMP Provide construction site management plan, including location of dumpster and portable toilet. Right- ❑
of-Way Permit is required if using right-of-way for construction parking.
DPLN Provide drainage plans showing site topography(flow arrows, etc.) ❑
ESCP Provide erosion and sediment control plans with installation details. ❑
IMPS Provide impervious surface calculations for entire lot (existing and post construction). ❑
Section 24-66(b) of the Land Development Regulations requires on-site storage for increased run-off if
LDCS adding 400 SF or more impervious surface. Provide Delta volume calculations and on-site retention ❑
required per Section 24-66(b). (See attached information sheet.)
MEET Recommend Owner/Contractor meet with Public Works Director to discuss proposed construction. ❑
Call 247-5834 to make an appointment.
REPM A Revocable Encroachment Permit must be obtained. ❑
RMRO II runoff must remain on-site. Cannot raise lot elevation without measures to retain runoff. ❑
RWPM Right-of-Way Permit must be obtained for use ❑
TSUR Provide a pre-construction topographic survey prepared by a Florida Licensed Professional Land ❑
urveyor, showing 1' contours.
CONDITIONS OF APPROVAL TO PRINT ON PERMIT:
II concrete driveway aprons must be 5" thick, 4000 psi, with fibermesh from edge of pavement to the
DAPR property line. Reinforcing rods or mesh are not allowed in the right-of-way. (Commercial driveways– ❑
6"thick.)
Full erosion control measures must be installed and approved prior to beginning any earth disturbing
ECIN activities. Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start
of construction.
OSRO All runoff must remain on-site during construction. ❑
PCTS If on-site storage is required, a post construction topographic survey documenting proper construction ❑
ill be required.
PLWP Pool–Wellpoint (if used) must discharge into vegetated area 10' minimum from street or drainage ❑
feature (swale, structure or lagoon). A separate pool permit is required.
ROFF Roll off container company must be on City approved list and container cannot be placed on City right- ❑
of-way. (Approved: Advanced Disposal, Realco Recycling, Republic Services, Shappel's and Waste Pro).
RWRS Full right-of-way restoration, including sod, is required.
URCT Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid 10 ❑
feet in each direction from the center of the cut. Repair must be shown on the plans.
BUILDING PERMIT APPLICATION FFA
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 4
Office (904) 247-5826 Fax (904) 247-5845
My-
Job Address: L z�& 3�233 Permit Number:
Legal Description 5,r,Oia Parcel #
Flcfor Area of Sq.Ft. -fit
Valuation of Work$ 7j COO Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Moveemoliti 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 product approva orm
Describe in detail the type of work to be performed: ot*g1e_*r_ Noo,S - Dern c) —
A/P sµ 4. 6vOAC�, Ntk5
Property Owner Information:
Name: . 8qK + �� (/, �� �f Address: q t?0 OC66,_ Z)JA_
City '3h State/ Zip 333 Phone 909-
E-Mail
i O tl-
E-Mail or Fax#(Optional) �s / to I,�•�.es , �,�-. \rjoy_34 1 ZNio3
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: 'Ek}p (f 05•6-4 NO►'lero 3%1 s, Qualifying Agent: C 6. , - e c- �P+.bey-+6 b�
Address: 3414 QTc. // yh _,5)- City ,4�,<Jc,��i� /3�TState�Zip 3;?233
Office Phone 944-34T-2903 Job Site/Contact Number
State Certification/Registration# C C5LC6'q X0
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 certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be pet formed 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 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.
I hereb certify that 1 Pdexaned this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type o) work will be cer specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any otheal law regulating construction or the performance of construction.
Signature of OwneSignature of Contractor
Print NameQom'..... Print Name ��`/is.........
Before me Be e
this of 20 s Day f 20
No ey raham ary u i
My Commission FF 086990 hirley Gra
F 6990
or Expires 02/14/2018 8�
+o,a� E pires 02114/2 ised O 1 6.10
TO: Doug Layton, Director
City of Atlantic Beach, Public Works
FROM: Chris Lambertson
Elite Homes, Inc
DATE: April 23, 2015
SUBJECT: 130 Club Drive. Atlantic Beach, FL
1) Parking will be on the city street as noted on the Construction Site
Management Plan (CSMP).
2) There will not be a construction trailer on this site. The unloading and loading
area and material storage are identified on CSMP.
3) Location of chemical toilet is identified on CSMP and will be located on
owner's property with door facing construction project.
4) Dumpster location is on CSMP and an approved dumpster company will be
used.
5) Traffic control pattern is shown on the plan with entrance to property.
Adequate parking is available on the street.
6) The site will be cleaned and picked up for all debris including construction
material and all other trash regularly.
7) Erosion and Sediment Control will be maintained throughout construction.
There will be a silt fence on all four sides of the property. Inspection by Public
Works of erosion and sediment control will be done prior to commencing
work. All siltation will remain on-site during construction. All run off will
remain on site during construction.
8) If city inlet falls within driveway, owner will adjust top of inlet at owner's
cost.
9) Drainage and Retention plan will be submitted in a separate document with
the permit submission per Atlantic Beach City Ordinance. A post construction
topographical survey will be performed documenting proper retention.
10) Concrete driveway will be 5 inches thick,4000 PSI with fiber mesh from edge
of pavement to property line (in right of way). Reinforcing rods or metal mesh
will not be placed in city ROW.
11) Right of way will be restored to its original condition.
12) Any utility cuts in road made by contractor with be overlaid 10 feet in each
direction from the center of the cut.
n ction survey will be provided with 1 foot contour lines and
13) A preco stru y
submitted with permit application for construction of home(prior to any
disturbing of the earth)
ORDERED BY:
f '
The Law offices of Rod Schioth
z
2187 S Third St w: g
Jacksonvitte Bch, FL 32250 • t -' �-
904-372-9351 Y
beach@rod-iaw.com ---
• SURVEY NUMBER:FL1308.0045
PROPERTY ADDRESS: 130 CLUB DRIVE ATLANTIC BEACH,FLORIDA 32233
FIELD WORK DATE:a/&W3 REVISION DATE(S);cRmo 8/6m'3)
FL 1308.0045 ��vt` `A,
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POINTS OF INTEREST
FLOOD INFORMATION: WITH THE LOCAL GOVERNING NONE VISIBLE
By PERFORMING A SEARCH
LMUNICIPALITY OR WW\N.FEMA.GV THE PROPERTY OCATED IN ONE ISP OPEOR'Ty WAS FOUND THE ECCITYTOBE
ATLANTIC BEACH,COMMUNITY NUMBER 120075,DATED 06/03/13.
AFFILIATE
CLIENT NUMBER:8513-1651
DATE: 6/6!2013 MEMBERS
IF
BUYER:DAVID R SHIELDS&JANET C SHIELDS
SELLER:GERARDO MONARI BALBONI,11&LELA CAMP BALBONI
CERTIFIED TO DAVID R SHIELDS&JANET PA��REPLIB C kC A r,dcom
E LAW
OFFICES OF ROD S
NATIONAL TITLE AND INSURANCE COMPANY;N/A
Land Surveyors, nc. PBSb73S791b•F8bS744N13
1IM FWrwq L•-Dft Suite t-R NY"833913
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