1021 ATLANTIC BLVD - INTERIOR DEMO (----j rA.,`l�
---
� S, CITY OF ATLANTIC BEACH
-4.. - l 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-2907
Job Type: DEMOLITION
Description: INTERIOR DEMO UNIT 975
Estimated Value:
Issue Date: 12/16/2015
Expiration Date: 6/13/2016
PROPERTY ADDRESS:
Address: 1021 ATLANTIC BLVD
RE Number: 177602-0040
PROPERTY OWNER:
Name: EQUITY ONE ATLANTIC VILLAGE,
Address: 16 NE MIAMI GARDENS DR ATTN: TREASURY DEPT
GENERAL CONTRACTOR INFORMATION:
Name: DIMENSION CONSTRUCTION (GC)
Address: 1045 N LIBERTY ST QA RAMIN PARTOW
Phone: - -
PERMIT INFORMATION:
FEES:
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Demolition Fee $100.00
Total Payments: $104.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TIW FLORIDA
BUILDING CODES.
41, '
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH C ii
t0 Seminole Road,Atlantic Beach, FL 32233 /"
•• Office (904)247-5826 Fax (904)247-5845 9 b 1
Job Address: 1S '11c0n /i C )Vd A41c„1 c y - - A C 32 3Permit Number:
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Legal Description 8-23-2?6"1q. ,4o Cv� r '
r. Ferrer at,,-f �1
�� z�9 Parcel #
Valuation of Work$ 1 4 SO oor ' ea o q. t. t
Proposed Work heated/cooled _ _ non-heated/cooled pU
Class of Work(circle one): New Addition Alteration Repair Move Cpemolition pool/spa window/door
Use of existing/pro osed structure(s)(circle one): IrOMMEO If an existing structure, is a fire sprinkler system installe 1 . irc e one):Res Yes ti No N/A
Florida Product Approval# n// /nit vtcr fo I k On
For multiple products use product approves rm
Describe in detail the type of work to be performed: / �Ii 0 r -Ki 0
Property Owner Information:
Name: E P. wile A-11a a/rc VJlkga, Mc-
City NeY IA /''1►ct�„ Address: 1 o(�OO fir I�M l e� - b r
Bch State 3317 9 Phone I04i) .2 1,2 - 2.222
E-Mail or Fax#(Optional) v - I
Contractor Information: CONTRACTOR EMAIL ADDRESS: P' 6, +0 k)
et( I, 0
Company Name: .Dl hS/on CO 4 loh
Address: 10 r/d�k L,I,erll eat' Qualifying Agent: ., • �n ►Q ,�,
Office Phone 41)2y q-(0 j4 Job Site/Contact Number �y �nc�t if State F L Zip Z•
State Certification/Registration# C G C 1S0 8 41 Q 0 2 4 ��g 4 Fax# 0`f -8 3
Architect Name&Phone# AE- S-luoito Archt-ecJure (321) 61.5- C1 F 1
Engineer's Name&Phone# At/,q.
Fee Simple Title Holder Name and Address .
Bonding Company Name and Address 4
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I certib,that no work or installation has commenced prior to the
issuance ofa 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.
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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.
Ve l herebby cert that I have read and examined this a plication a . ow e -.to be true and correct. All provisions of 1.•s• d ord. ane. go erning this or it.rovisions of any other complied al,tate, or local ta specified herein cons cti •er of a permit onst not presume to gz au ority o vi ate o cancel the
�- •erformance of construction.
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>ignature of Owner / a
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Signature of Con�u:
'riot Name A ( M�r z a E / -
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E Print Name
;efoLe me 20 • Z Befor.. -
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