42 11TH ST DEMO J ' -' `._ CITY OF ATLANTIC BEACH
j , , 800 SEMINOLE ROAD
`.. - ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
\ JS3l9 r-
DEMOLITION PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- DEMO -298
Job Type: DEMOLITION
Description: DEMO HOUSE
Estimated Value: $14,270.00
Issue Date: 3/7/2016
Expiration Date: 9/3/2016
PROPERTY ADDRESS:
Address: 42 11TH ST
RE Number: 170269 -0000
PROPERTY OWNER:
Name: TUCKER TRUST, ADELAIDE R
Address: 42 11TH ST
GENERAL CONTRACTOR INFORMATION:
Name: INSPIRED HOMES LLC
Address: 2215 3Rd ST
Phone: 904 - 237 -2711
PERMIT INFORMATION: PUBLIC WORKS:
Strongly suggest good documentation of impervious dimensions be recorded.
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.
No grading to raise site elevation is allowed.
Full right -of -way restoration, including sod, is required.
Full site to be grassed.
Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid 10
feet in each direction from the center of the cut. Repair must be shown on the plans.
Slab and driveway to be fully removed.
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
e `s4 CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
J �� -. ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
� JJil�
Demolition Fee $100.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $104.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
syvt, City of Atlantic Beach
APPLICATION NUMBER
� ) Building Department par (To be assigned by the Building Department.)
800 Seminole Road r
— Atlantic • Beach, Florida 32233 5445 J ! q /4' — ,�j9) !1' — O t�
Phone (904) 247 -5826 • Fax (904) 47 -5845 106
ri;31s)% E -mail: building- dept @coab.us f Date routed: 2 I, • City web -site: http: / /www.coab.us ,,
APPLICATION REVIEW AND TRACKING FORM
Property Address: l b - // ST Department review required Yes No
Building
Applicant: AS f _A ih 1)1c6 Planning & Zoning
/1/2
Tree Administrator
Project: �� is workrk - s
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. 1 (Denied.
(Circle one.) Comments: �/� �j �j,�
BUILDING J Afu6""" "mo "
PLANNING & ZONING
Reviewed by: ,4 ,, /
VV Date: 41/16
TREE ADMIN. Second Review: 1 (Approved as revised. ❑Denied.
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
CITY OF ATLANTIC BEACH
800 Seminole Road. Atlantic Beach. FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: Z t S'T, Ac ,,,r. -c►c_ (I FL 322 Perth N rtmher-
Legal Description Col" q 1) '`I ' • -� to �t k - ,n'.rrus B<N p paw ci
Floor Area of Sq.Ft. Sq.Ft
6
FF
-
Valuation of Work S �,�- ` Proposed Work heated /cooled no e d cook
Class of Work (circle one): New Addition Alteration Repair Move a molitio pool /spa window /coor
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
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: P %-k kb•' I �
Property Owner Information:
Name: V r' c-1 &,t t te_,s. Address: 2-M S12- MO Ss Ce-t-0-1.— l._chm..4- twee. 3 O
City �.�, p , V e� 3,-c $ State Ft- Zip '52,0E Phone
E -Mail or Fax # (Optional)
Contractor Information:
Coinpany Name: r�es � � M e . S ( - t - c d Qualifying Agent: kur1 V d-e-r O r -
Address: 22-16 S. ro ST City t■•1.. Be› State Zip 32.2S
Office Phone 904 VYJ- 2'? I I Job Site/Contact Number Fax # — limo
State Certitication/Registration # C C.- o 5 'tq 7 S
Architect Name & Phone # KEV114 G,C Y — - 75'9 -
Engineer's Name & Phone # ■"av Tb 071 C • — 2. -2_ on _
Fee Simple Title Holder Name and Address L j1
Bonding Company Name and Address 1 J 14
Mortgage Lender Name and Address
•lpplkainmt is herchr made to obtain a permit to do the work and installations as indicate 1 certili that no work or installation has commenced prior to the
issuance of a permit and that all work 11 ill he performed to meet the standards aJ all laws regulating (Unstru( - lion 111 this jurisdiction. This nerlliit becomes !lull
and void if work is not commenced within six (61 ntaniln. or if construction or 11 ark is stnI lends•(/ or ahamdnn(•J tar o /term(/ of six (6l mo at any rinse Wier l
work is commenced. I understand that separate' permits mtrst he secured jar Electrical Work. Plunthing. 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.
1 herein certili that 1 have read and examined this application and know the sante to he . true and correct. All provisions of laws and ordimanc•es gorerning this
ttpe of work" frill he complied with whether spfeelped herein or trot. The !;ranting o1 a permit does not presrnne to give authority o ril tie or cancel the
provisions of any other /i Jerai. state or local law regulating construction or the perlornrn tee ell constructi f
Si of Owner .' rOjilA)0 Signature of Contractor
Print Name . e .� ►1S(L..... .__ Print Name sc-x —r do,
Sworn to and subscribed before me Sworn to . I I ubscribed before me
this gt Day of - ,..- . 20 (LI this \ u a • . t -2z k1 - � - - . 20 ( L'
= e: JEFFREY E TABS :r
=-. . . ' r ' • B ' MY COMMISSION # FF916223
Not • ' , e ' EXPIRtb septem 1rc1 g
� i 30 :) $9 2f -015
Notary 'u 'tic a t , • E XP IRES September 13, 2019 F brideNom Sw.,
(4 0 7 3 53 FwrldaPiOtartsorvka,brt: _ orvl - -
go1, imvi -i ATLANTIC BEACH BUILDING DEPT.
.,
`� aft DEMOLITION — PROPERTY OWNER
, s RELEASE FORM
�t
Date: Feb 4 2016
To Whom It May Concern: 9 4-1° x c -1 LJ sC 1 F*
1 / We the current property owners of: Lot 4
Block 41 Atlantic Beach
Legal Description of Property
AKA 42 11th Street have contracted with to have
(Address of Property)
Inspired Homes LLQ oremovethe Duplex
(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.
762/ .06
{
Sign ure
V / ' A4 A_ / . - ,
Signature
THIS SPACE FOR RECORDER'S USE ONLY
POSNAW
Signed: • Date: �' (: �-
raP " 'k.? JEFFREY E TABS Before me th' day of in the -County punt} of D gal. State
.9 MY COMMISSION # FF916223 Of Florida. a rsonally appeared — e'�o �, 'k4
''If,� '' EXPIRES September 13, 2019
Notary Pu Large. State of Florida. Couhty uval.
iea ab Rt4H dMdt+p+rysarvlca.can My comet .n expires:
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Personally 'now n: or
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