645 OCEAN BLVD - INTERIOR DEMO � " ; : `S, CITY OF ATLANTIC BEACH
_ f 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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DEMOLITION PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-DEMO-559
Job Type: DEMOLITION
Description: INTERIOR REMODEL - DEMO
Estimated Value: $1,000.00
Issue Date: 3/9/2016
Expiration Date: 9/5/2016
PROPERTY ADDRESS:
Address: 645 OCEAN BLVD
RE Number: 170126-0000
PROPERTY OWNER:
Name: Inch-lob, Joseph
Address: 645 Ocean BLVD
PERMIT INFORMATION:
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Demolition Fee $100.00
Total Payments: $104.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
‘10".# BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904)247-5845 1 GO— ti E/V\d-SS p
Job Address: 6 V5-- (F 7 - Q i. J
,,,,,,7 4/7,- - Permit Number:
Legal Description ' - 6 - •- :77
-a- Parcel # / � -c,�>v
Valuation of Work$ / o0 oor ' ea o q. t. t
Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Movc enrol' a 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
Florida Product Approval#
For multiple products use product appiThqs—Tifforn
Describe in detail the type of work to be performeI. _ Y
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Property Owner Information:
Name: JcS4l� !n di`Io10
/ - ‘.1, , C• /4: Address: ' y a
City ,9-G,so -� ,,€c St /i S State LZi /�
E-Mail or Fax#(Optional) �- p 3 hlshone °� % ��
•
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name:
Address: Qualifying Agent:
Office Phone City State Zip
State Certification/Registration# Job Site/Contact Number Fax#
Architect Name&Phone#
Engineer's Name&Phone# - - id
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:f 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'Fork,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.
t hereby cert fy that I have read and examined this a placation and know the same to be true and correct. All provisions of laws and ordinances governing this
!ype ofwork 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 federal,state, or local law regulating construction or the performance ofconstruction.
Signature of Owner 4011S ...:r'�
ic ) Signature of Contractor z../
rent Name
•LZLe_ �� �'�•��••�/� Print Name �,
3efor �
zis _ Viii ay of(MVO JA. 20 _ �' Before me p✓
/ , lti , TON 1 i .' °' 20
AV ���e •■ MY COMMISSION t FF 924951
fotary 'ublic — s ue=•' EXPIRES:Octobcr ti 2019
410 Revised 01.26.10