280 Camelia St - Demo House J+'
1
, 1� 's, CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
O t li =" 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 -411
Job Type: DEMOLITION
Description: DEMO HOUSE
Estimated Value: $7,856.00
Issue Date: 2/19/2016
Expiration Date: 8/17/2016
PROPERTY ADDRESS:
Address: 280 CAMELIA ST
RE Number: 170862 -0000
PROPERTY OWNER:
Name: BENNETT, F REUBEN & SARA E, *
Address: 280 CAMELIA ST
GENERAL CONTRACTOR INFORMATION:
Name: JAX DIRTWORKS INC
Address: 334 PEREGRINE CT JENNIFER HOLDEMAN
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.
Full right -of -way restoration, including sod, is required.
Full site to be grassed.
No grading to adjust site elevation is allowed.
Slab and driveway to be fully removed.
FEES:
Demolition Fee $100.00
a z i cvairpti 'klkg ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
' CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
STATE DBPR SURCHARGE $2.00
Total Payments: $104.00
Ill
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
rrst.tw City of Atlantic Beach
, Building Department
APPLICATION NUMBER
j� is - _ , 800 Seminole Road
(T o be assigned by the Building Department.)
Atlantic Beach, Florida 32233 -5445 - - i// /
K
Phone (904) 247 -5826 • Fax (904) 247 -5845 7
`'�_1; i >r E -mail:
i building -
dept @coab.us Date routed: 2
City web -site: http: / /www.coab.us --my i
APPLICATION REVIEW AND TRACKING FORM
Property Address: .1 ) t) ( i T Department review required Yes No
� Buildin g
Applicant: A -/ / ,0,, S' Planning & Zoning
Tree Administrator
Project: - ublic VVork�
Public Utilities
Public Safety
Fire Services
.Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
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:
APPLI ATION STATUS
Reviewing Department First Review: 1 ktro,pproved.
(Circle one.)
Denied.
Comments: ,--/e,1 ��� /� L�%�L� �/!l /�t�%li
Reviewed by:
BUILDING �I/ %vy`
PLANNING & ZONING /4 _ il j (_ _
' V Date: Z 11 r/ C
TREE ADMIN.
Second Review: 1 (Approved as revised. 1 (Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
•
PUBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES Third Review: 1 (Approved as revised. 1 'Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
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PUBLIC WORKS PLAN REVIEW COMMENTS
Date: ,y// 1 // (o Application Permit #: / - OG in 0 - y//
Project Name / Address : ) g 6 e._ a me- O G Sk -
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 All runoff must remain on -site. Cannot raise lot elevation without measures to retain runoff. ❑
RWPM A Right -of -Way Permit must be obtained for use . ❑
TSUR Provide a pre- construction topographic survey prepared by a Florida Licensed Professional Land ❑
Surveyor, showing 1' contours.
CONDITIONS OF APPROVAL TO PRINT ON PERMIT:
All 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 Er
of construction.
OSRO All runoff must remain on -site during construction. I2
PCTS If si t v a a g e i r c e r l r e d r a i l e s t c: , ru ' • . : • • , : • • • . • • m- i iag ion
will be requi red ..41 ) , z f NA poc ✓ , ka, 0 f' f''1' ,ez,,,4v1Ji° .4 pi�40"
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. e
tv!(Ji11 40 he rwe
Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid 10
URCT ❑
feet in each directi on from the center of the cut. epair must be shown on the plans.
'Y 4 g'I" ' 4o i i4/,iii -4 �� e ei ✓' 410-1, 1/
J /a (4t ir,veW .40 he vlb pelaeJd
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 280 Camelia Street Permit Number:
Legal Description 18-343A-2S-29E .492 ATLANTIC BEACH SEC H LOTS 1,2 BLK 100, LOT 1,N 20FT LOT 2 BLK 99
Parcel # �'�$(�,2 - Q()
r (511. -- (511. Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ i 5 0 Proposed Work heated /cooled 1 � 0 0 non- heated /cooled / C7
Class of Work (circle one): New Addition Alteration Repair Move emolition pool/spa window /door
Use of existing /proposed structure(s) (circle one): Commercial
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval #
For multiple products use product :jii r • •. \ 1„,,, Describe in detail the type of work 1 l , : p- . y<. 1]k,� svl r -' - _ , % V .
1 1111 Property Owner Information: 1 ( 314 - y �q - 5
Name: L L o A 9 1 AVM A.. e . L,, / /
City . __ . _ Phon:
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: ZJ,2 < 5 r r - {W (k5 )1( _ Qualifyin l A l ent: Je a_
A t "r • ..
Address: ?>t( S a ,L�r City a i■ , haf 4- ; • State Zip .,
Office Phone Lp g 3 —, '31(9 Job Site/ Contact Number S MS ' C, ! r (j j Fax # _ , - 235_
State Certification/Registration # YYl - (-9.61
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 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 sus ended 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 Elecmicar Work, Plumbing, Signs, Wells, Pools, F urnaces, 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 certify that 1 have read and examined thisplication 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 specs ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor „I
Print Name Print Name Limn „, r A
Sworn to and subscribed before me Sworn to and subsc • • • • before me
this Day of , 20 this i Day of A , Al 20
c
" //A 'v 40 . . •r . Public State rd Finned
Notary Public otary 'Tie lc .1, • _ „ MY Commission FF 164674
-. OFVii '2PtP
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Estimate
0 1 Estimate # 16 -189
1
-..,. Date 1/19/2016
Terms Due on receipt
Jax Dirtworks Inc.
310 Mealy Dr Atlantic Beach FL 32233
(904) 683 -3124 Office (904) 683 -3352 Fax
www.jaxdirtworks.com
Contractor Job Address
City of Atlantic Beach 280 Camelia St
1200 Sandpiper Lane AB, FL 32233
Atlantic Beach, FL 32233
Scott Williams / Ph. 247 - 5834
silliams @coab.us
P.O. No.
Description Qty Rate Total
Demo 1,484 SF House & Driveway - -- with Sheds and Dock 7,856.00 7.856.00
- -- Includes Silt Fence and Permit
Acceptance of proposal - The above or attached prices and specifications are
satisfactory and are hereby accepted. You are authorized to do the work Subtotal X7,856.00
specified.
Accepted this day of , 20 Total 57.856.00
Signature of Acceptance:
Printed Name & Title:
CITY OF ATLANTIC BEACH
PURCHASING PURCHASE ORDER
'I PHONE (904) 247 -5880
FAX (904) 247 -5819 P.O. NUMBER DATE
, .,, 160790 02/12/16
/
THIS P.O. NUMBER MUST APPEAR ON ALL INVOICES
PACKING SLIPS. LABELS. BILLS OF LADING AND
CORRESPONDENCE
VENDOR: SHIP TO:
JAX DIRTWORKS INC. CITY OF ATLANTIC BEACH
310 MEALY DRIVE ATTN: PUBLIC WORKS DEPT
ATLANTIC BEACH, FL 32233 1200 SANDPIPER LANE
ATLANTIC BEACH, FL 32233
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VENDOR # DATE NEEDED TERMS
REQUISITIONED BY
5157 02/29/16 NET SHOWMAN /S. WILLIAMS
F.O.B CONTRACT NO. ACCOUNT NO. PROJECT REQ. NO. REQ. DATE
00160205723400 96417 02/02/16
LINE QUANTITY UOM ITEM NO. AND DESCRIPTION UNIT COST EXTENDED COST
1 7856.00 DL DEMO 1,484 SF HOUSE AND DRIVEWAY 1.00 7856.00
WITH SHEDS AND
DOCK INCLUDES SILT FENCE AND
PERMIT , EST MATE
#16 -189 DATED 1319/16. LOCATION:
280 CAMELIA ST.,
ATLANTIC BEACH, FL.
VENDOR ITEM NO.- EST. #16 -189
SUB -TOTAL 7856.00
TOTAL 7856.00
REMARKS:
ATTN: JENNIFER JENNIFER @JAXDIRTC10RKS.COM
CITY CONTACT: SCOTT WILLIAMS, 904 - 247 -5834
NOTICE CERTIFY THAT THE ABOVE PURCHASE 15 NECESSARY FOR THE
PROPER OPERATION OF THE CITY OF ATLANTIC BEACH AND
PLEASE SEND INVOICE TO: THE FUNDS ARE APPROPRIATED IN THE CURRENT BUDGET
CITY OF ATLANTIC BEACH `�t� /� ` „� - c
ATTN: ACCOUNTS PAYABLE CLERK ` '
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233 PURCHASING AGENT
THE LAWS OF THE STATE OF FLORIDA. U.S.A. SHALL GOVERN IN
CONNECTION WITH THE FORMATION, PERFORMANCE. AND THE
FEDERAL TAX I D # 59-6000267 LEGAL ENFORCEMENT OF THIS PURCHASE ORDER
STATE TAX EXEMPT # 85- 8012740083C -8
Drake, Patricia
From: Williams, Scott
Sent: Tuesday, February 16, 2016 9:37 AM
To: Drake, Patricia
Cc: Moore, Kayle
Subject: RE: PO 160790 Attached
Patty,
Dirt works is suppose to be in today filling out all the paperwork to get there permits to do the demo. I told them that I
would try to make sure we walked the permit through so they could start tomorrow.
Scott Williams
DeputyPublic Works Director
City of Atlantic Beach
Office: (904)247 -5834
swilliams@coab.us
From: Drake, Patricia
Sent: Tuesday, February 16, 2016 9:23 AM
To: Williams, Scott
Subject: FW: PO 160790 Attached
Importance: High
H i Scott,
I sent the attached PO to Jax Dirtworks before 2 PM on Friday. I haven't received a confirmation of receipt, and was curious
if they started the demo today?
Thanks„
Patty
From: Drake, Patricia
Sent: Friday, February 12, 2016 1:48 PM
To: 'Jennifer Holdeman'
Cc: Williams, Scott
Subject: PO 160790 Attached
Importance: High
ennifer,
'lease confirm receipt of the attached P0.
"hank you,
'arty Drake
'urchasing Agent
;ity of Atlantic Beach
1
Phone: (904) 247 -5880
Fax: (904) 247 -5819
pdrake @coab.us
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