1973 COLINA CT - INTERIOR DEMO 01-A1‘.1:1'16
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CITY OF ATLANTIC BEACH
A -, 800 SEMINOLE ROAD
s)
Zs' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
—0111!
DEMOLITION PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-DEMO-1886
Job Type: DEMOLITION
Description: INTERIOR DEMO
Estimated Value: $100.00
Issue Date: 8/6/2015
Expiration Date: 2/2/2016
PROPERTY ADDRESS:
Address: 1973 COLINA CT
RE Number: 169506-1062
PROPERTY OWNER:
Name: PEREZ, PAUL I
Address: 1973 COLINA CT
GENERAL CONTRACTOR INFORMATION:
Name: ULTIMATE CONSTRUCTION
Address: 4054 W ARBOR LAKE DR JAMES VAN ARSDALE
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 'HIE 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 MAO
Job Address: 1113 CO l,1Nq (_Dtl Permit Number:
Legal Description Lot 4 ■ ° i w iT Parcel#
0.0o Floor Area of Sq.Ft. q, t
Valuation of Wor, ', 10 Proposed Work heated/cooled non-heated/cooled
Class of Work(circ • i 1 . • New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial eside ties
If an existing structure, is a fire sprinkler system installed?(Circle one): es No 7A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: 0_4306 OF 1 (v2(I4 ,US fir.
14-ti hero A Maul/ l 4hr poN► (,71-r,Q.,k004._)
Property Owner Information: a /n��n,
Name: 1 % Q5 Address: VIM UO1 if lct Cali+
City i .e . State Zip 32233 Phone log . $gbl
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: , t a t (' �i",1 , I I 1 a _ Qualifying Agent: et I►1 �t
Address: it 3%0 LJci/,e, I�, , City V State t Zip 32225
Office Phone 2.3y- n2,4,, Job Site/Contact Number ., 15101 Fax#
State Certification/Registration# GBC.. MI5 r 61
Architect Name&Phone# tVAc
Engineer's Name&Phone# AA
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 certifi,that no work or installation has commenced prior to the
issuance?fa 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 f work is not commenced within six(6)months, or if construction or work is suspended or abandoned for aperiod of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for ElectricalWork,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 hereby cert fy that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type ofwork will be complied wi hether s mired herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,sta , r 1 1 w egulating construction or the performance of construction. I
Il i
Signature of Owner Signature of Contractor I,
Print Name Pity V T. Pt/c L Print Name 10.4 F
hisor' 11 t ay of i<. .20 5 this O p` Day �� ``-kro..T A 0 'I4
L� ir _ , NIVIA COX A.A:�" MY Comm.ExpiresL
Notary Public r; f No�tyF'ublic-SW*NOM •�,Pu.he-- •r � rvo F `8 613 ;—.
•?.ft.)MY Comm.Expires Nov!1 201 .N AV Commission I EE 5$ �:
''kegs' eo.Nw Ttro1.NMONNI ., Aso. Red `9 p'{;bit �y�Q. $
4
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