1303 OCEAN BLVD - INTERIOR DEMOmmom_ _ __ __
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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-2251
Job Type: DEMOLITION
Description: interior demo
Estimated Value: $100.00
Issue Date: 9/24/2015
Expiration Date: 3/22/2016
PROPERTY ADDRESS:
Address: 1303 OCEAN BLVD
RE Number: 171835-0000
PROPERTY OWNER:
Name: PRIDGEN LIFE ESTATE, MARIAN S, *
Address: 1303 OCEAN BLVD C/O DAVID M PRIDGEN
GENERAL CONTRACTOR INFORMATION:
Name: PHILLIPS BUILDERS LLC
Address: 1250 SELVA MARINA CIR QA BARBARA CAROLINE
PHILLIPS
Phone: - -
PERMIT INFORMATION:
FEES:
STATE DCA SURCHARGE $2.00
Demolition Fee $100.00
STATE DBPR SURCHARGE $2.00
Total Payments: $104.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND 771E FLORIDA
III II',DING CODES.
Wfr .
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904) 247-5845
Job Address: /363 0 GCS 0 t(>l11
J Permit Number: _
Legal Description Parcel#
Floor Area of Sq.Ft. t
Valuation of Work$ 166 --� Proposed Work heated/cooled non-heated/cot►lctl
Class of Work(circle one): New Additi•- 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 )�/fl I)
Florida Product Approval#
For multiple products use product approva orm \ v1�'N2 . IN T t e
Describe in detail the type of work to be performed: D t M cl
in4. 6
Property Owner Information:
Name: )4-44C bValL , PI41,(A,P‹ Address: / ZS'b Se ez PwivvIA C4'
City A.6 . StatefLZip 3 2 2,.7 Phone_________
E-Mail or Fax#(Optional) •
•
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: 91A'U-A-AP.S :10(t$ t,(..G Qualifying Agent:
Address: l Z.SO S. Vat M>a,RIN►• t■Q..
Office Phone gm. 4�- City A R, - State)-1 . Zip 3 Z �' �
�9°1 4 Job Site/Contact Number Fax#
State Certification/Registration# CSC, 125_"7 3 I$
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 certifil 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 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 hereby cert>fy an
that I have read d examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
.ype 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
7rovisions of any other feder 1,state, or al law regulatin construction or the performance of construction.
signature of O ��� \
Signature of Contr
'rint Name ,/ Iedm.[, pkiti,ekii4 Print Name /
;: / Be • e
�Da, of �i� c!
• r,4 V. , 20 t r /�'i:y o ,t•.�.&a • I g'•►
J • iiiiP, k•a Public State of Florida _ WI Notary Public State of Fbrida
Shirle L Graham
My Commission FF 086990 Expires 02/74!2018
ore'. Expires 02!14/2018
,rM 4446. 'evised 01.26.10