328 5TH ST - DEMO PERMIT CITY OF ATLANTIC BEACH
s5- 800 SEMINOLE ROAD
�„ 5-) ATLANTIC BEACH, FL 32233
J INSPECTION PHONE LINE 247-5814
DEMOLITION PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-DEMO-930
Job Type: DEMOLITION
Description: demo garage and driveway
Estimated Value: $5,000.00
Issue Date: 4/25/2016
Expiration Date: 10/22/2016
PROPERTY ADDRESS:
Address: 328 5TH ST
RE Number: 169834-0000
PROPERTY OWNER:
Name: GOODLING, LOUISE 0
Address: 328 5TH ST
GENERAL CONTRACTOR INFORMATION:
Name: BEETREE HOMES
Address: 13751 SAXON LAKE DR KATRINA HOSEA
Phone: - -
PERMIT INFORMATION: PUBLIC WORKS:
Strongly suggest good documentation of impervious areas.
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.
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,Shapell's,Sunshine Recycling and
Waste Pro).
Full right-of-way restoration, including sod, is required.
Elevation cannot be raised.
Full site to be grassed.
Right-of-way to be sodded.
_ DA
BUILDING CODES.
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A 4. , � , CITY OF ATLANTIC BEACH
A "'s-) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
`' INSPECTION PHONE LINE 247-5814
�'�J3319�
FEES:
Demolition Fee $100.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $104.00
I
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PERMIT IS APPROVED ONLY IN ACCORDANCE WITII ALL CI I V OF Al lANTIC I3EACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
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BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach,FL 32233
Office (904) 247-5826 Fax(904) 247-5845
Job Address: 3.:: 8 e.4" S T TEZT Permit Number:
Legal Description
Parcel# )Sq.Ft( 9 3`f - p°°d
eo Floor Area of Sq.Ft.
Valuation of Work S 5,000 Proposed Work heated/cooled- non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial 'esidentia II
If an existing structure, is a fire sprinkler system installed? (Circle one): • - 40 N /A
Florida Product Approval #
For multiple products use product approval form .
Describe in detail the type of work to be performed: Rtn o-'E_ &AFZraG-e_ Ai)la DR-A/iE•✓g1-1
Property Owner Information: ,
IS Name: --56lr 4 SA6R,WA A -.t! ( Address: 61839 NE..a.C.1C5 £& DR,v>l<.
City —514cirsalA►ite.. Staten Zip 37a24, Phone
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: 130G.x. IKe._ t- e Qualifying Agent: 1Cat ctA 'J
Address: 133Co1 An o,fant- 131+a City kSo 4 sz I$i '' ate r1 'Zip 3.2-a35
Office Phone SID-40D Job Site/Contact Number (3i-lob I D Fax
State Certification/Registration#
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 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.
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 MEN BEFORE MRECORDING YOUR NOTICE OF
1 hereby certify that 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing thi.
type of work 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
provisions of any other federal,state,or local law regulating construction or the performance of construction.
.1.
`Sc_ ' il-Ok-.K. -TOHM q:eg-60450/4
4gO 20 A,
--- Si gnature of Contractor
Agnature of Own- ; // ./ .., .
Print Name JOHN L FERGUSON
Print Name „......
• L FERGUSON
-*. ...1 MY COMMISSION X FF197554 i . ',i ..*: MY COMMISSION I FF197554
Sworn to and subj. , el :t 4- -. -_- Fobniary 09,2019 Sworn to and s e" :4-.."1:i.-, bekitIVILVF . ry 09,2019
..0" 20 this t3 Day of,* ' -. . -ryService.corn- -
zipZ this 13 Day ,..:. ". ...e.
21
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F'..--L.:.-a •-.....----.---..
Notary Public Notary Pug lc
, 1 :
Revised 01.26.10
St.:Ly;it, City of Atlantic Beach APPLICATION NUMBER
�s tisi �� Building Department ;,ter"1- �_— (To be ass/gned by thCe Building Department.)
• . 800 Seminole Road Pte + �(D �JG 7��
r� Atlantic Beach, Florida 32233-5445
V Phone(904)247 5826 Fax(904)247-5845�PR 2 1 £
E-mail: building-dept @coab.us Date routed: 24 i
City web-site: http://www.coab.us __
APPLICATION REVIEW ANibRJ !CKING FORM
Property Address: C:32, 8 S' ST- Department review required Yes No
G Building
D Applicant: C rn E� Planning &Zoning
T dministrator
O ) blic Works
Project: _Public Utilities
# IL W /. / Public Safety
Fire Services
Review fee $ Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required 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: She �q '�
BUILDING
PLANNING &ZONING Reviewed by: _4(e it) d4,vs.Date:pi�/,4,
TREE ADMIN. Second Review: ❑Approved as revised. ['Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ODenied.
Comments:
Reviewed by: Date:
Revised 05/14109