336 10th St - Demolition of SFR ( , /4).
10 CITY OF ATLANTIC BEACH
it j 800 SEMINOLE ROAD
J tr - =I 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: 16- DEMO -164
Job Type: DEMOLITION
Description: Demolition of SFR
Estimated Value: $16,750.00
Issue Date: 2/9/2016
Expiration Date: 8/7/2016
PROPERTY ADDRESS:
Address: 336 10TH ST
RE Number: 170037 -0000
PROPERTY OWNER:
Name: BULL, KATHLEEN & NIELS, *
Address: 336 10TH ST
GENERAL CONTRACTOR INFORMATION:
Name: REALCO RECYCLING
Address: 8707 SOMERS RD QA JERRY J DOHERTY
Phone: - -
PERMIT INFORMATION: PUBLIC WORKS:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing
activities. Contact Public Works (247 -5834) for Erosion and Sediment Control Inspection prior to start
of construction.
All silt must remain on -site during construction. .
Strongly suggest good documentation of impervious dimensions be recorded.
Roll off container company must be on City approved list and container cannot be placed on City Right -
of -Way. (Approved: Advanced Disposal, Realco, Republic Services, Shappel's and Waste Pro.)
Full right -of -way restoration, including sod, is required.
Full site to be grassed.
Slab to be fully removed.
FEES:
Demolition Fee $100.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
0 !-�l y:r
�� ff�� � CITY OF ATLANTIC BEACH
- s) 800 SEMINOLE ROAD
!) tli .:1 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
'rte J331>
STATE DCA SURCHARGE $2.01
STATE DBPR SURCHARGE $2.01
Total Payments: $104.02
PERMIT IS APPROVED ONLY IN ACCORDANCE WITII ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
i it" s � Building Department _ D (To be assigned by the Building Department.)
" - 800 Seminole Road E__‘0 (\c)
's) Atlantic Beach Florida 32233 -5445 , Q 1 4
Phone (904) 247 -5826 • Fax (9041247 -5845 22 2016
�J;i10- E -mail: building- dept @coab.us ipt y° Date routed: d -
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: \, O' Department review required Yes No
(� Building
Applicant: \��C�\ C ��� k \r;._ Planning & Zoning
Tree Administrator
Project: \�� --YV�� `� C� (� _ Public Wor
Public 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: Approved. ❑Denied.
(Circle one.) Comments: Jet /c4d C�, '
��lr/ G4
BUILDING
PLANNING & ZONING Reviewed by: 44 Date: 2 414
TREE ADMIN. Second Review: Approved as revised. nDenied.
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
BUILDING PERMIT APPLICATION \v \�j - `L
CITY OF ATLANTIC BEACH - C
800 Seminole Road, Atlantic Beach, FL 32233 \U-
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 3 3 6 I. O TH S i , k LA-1J i 1 Icait. 0 , 3ZZ33 Permit Number:
Legal Description L GI ',5 ° 1-47 « pJ t- \I-- Parcel # 11,O 03/ oo O
Floor Area of Sq.Ft. .Ft
Valuation of Work $ ((j i 760 Proposed Work heated/cooled 3( n heated /cooled eq
Class of Work (circle one): New Addition Alteration Repair Mov; Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): Commercial ' esid• t i.
If an existing structure, is a fire spri kler system installed? (Circle one): ' es No N /
Florida Product Approval # 1- Pr
For multiple products use product approval form
Describe in detail the type of work to be performed: IoM. , - C - 7 L(,'6, D its 44thea-C-J>
6..
51, t ( � t2 1 —
Property Owner Information:
Name: V 4-T H/ R- 0 101-5 1 Ut...1._ Address: 1 (1 O 1 e.° 6-i'lekB r- S f
.
City Ni=PTVA/ 73i tq-C H Staters Zip 3226 6 Phone `? 0 Y - 751 - ft Z-9 2 - 61 - 385 - 71.5"--
E -Mail or Fax # (Optional) ,Vc2 B //0,t_'0/9 -u5/4 . e'vfy / 2- *'iTHye7 W/L ' /3VLL . co i7
Contractor Information:
Company N : R-t_RL C v R( G yC Lt N 1, CO , Qualifying Agent: z1.4 �i�
m i4'tis ,4t(
Address: `,7, 4 ZS �7 City State "FL. Zip 372 (o
Office Phone 151 t. l Job Site/ Contact Number 1 55 -3c>g I Fax #
State Certification/Registration # - Cie 055 t(.4,
Architect Name & Phone #
Engineer's Name & Phone # (' A -
Fee Simple Title Holder Name and Address
Bonding Company Name and Address /.�
Mortgage Lender Name and Address 4 (AA-
Application is hereby made to obtain a permit to do the work and installations as indicated. / 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 permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo 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 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 s eciped herein or not. The granting of a permit does not presume to give aut 'ray to violate or cancel the
provi of any other federal, state, or loc aw re • ' Ling construction or the performance of construction.
Signature of Owner �� �, 1 ,� ,�
Signature of Contra or
gn t Lrri -
Print Name )4 i El-S F th y Vi1 T }i7 10 LL Print Name -.-4 5 o\! . fr - zC
.
Sworn to and subscribed before me Sworn to and subscf . - a before me
_gy
this " Day of p 0 Ty 20 I L�,P this ca 0 Day of 1 . . Q _, 20 ( aO
• 17 .11 .. ,I' " ' . JENKINS
• .1 Pu . lic • . ry ub11c Notary Public, State of Flori a
0% ALE N. POWERS
°v .
Sti 11 e Mey Flora, 8
MY COMMISSION k FF 897944 Co ��{{ � t p
°. EXPIRES: July 12, 2019 ��IIIS N0: tC 187841
�'+� ' Bonded Thru Notary Pubic Underwriters
1lAit. ATLANTIC BEACH BUILDING DEPT.
- 1 r DEMOLITION — PROPERTY OWNER
r - :- s, RELEASE FORM
00 ) J :.r
Date: /._ /9 - 2 /6
To Whom It May Concern:
I / We the current property owners of: Lot UC) L5 Al
Block LZ
Legal Description of Property
AKA 336 0 Sii A -tiO T 1c Pr cti FL 3 2233 have contracted with to have
(Address of Property)
Rect.( co R' <I 1 Co to remove the .5 J C f fH it Y
(Company Name) (Single Family, Duplex, Commercial, etc.)
Prior to the construction of :
As a condition of issuing the permit we agree to the following:
1. All utilities are to be located and clearly marked.
2. Once house is removed, lot is to be graded and leveled.
3. All construction debris is to be removed from the property.
4. Affected area is to have grass or seed in place.
5. Erosion control devices will be put in place and will remain in place until grass
has covered affected area or new structure is completed and landscaping is in
place.
i
Sign.ture ,
i .4_
Sign. r-
THIS SPACE FOR RECORDER'S USE ONLY
OWNER
Signe : Da
Before m th is _ (j day of f0Dt in the Co H--rof �
Of Florida, has personally appeared ICS(- �hIPPtY� I1 tv d - a - s tl eu i I
Notary Public at Large, State of Florid. Cou ty of Duval.
My commission expires: l' 2.01C1
Personally Known: i or
Produced Identification: FL ID1, [ ypQ -519 -LP - -o
ALEX N. POWERS / 71 - ) ( DC- ' W CP-T '- ---i'
r
MY COMMISSION # FF 897944
%.��- ,',.fs EXPIRES: July 12, 2019 ,
tif eF g' Bonded Thru Notary Public Underwriters
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