363 12th St - Demo CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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-1088
Job Type: DEMOLITION
Description: DEMO HOUSE
Estimated Value: $1,000.00
Issue Date: 5/17/2016
Expiration Date: 11/13/2016
PROPERTY ADDRESS:
Address: 363 12TH ST
RE Number: 171917-0000
PROPERTY OWNER:
Name: SIMEONIDIS, SERGE
Address: 363 12TH ST
GENERAL CONTRACTOR INFORMATION:
Name: SIGNATURE HOMES & DEVELOPMENT
Address: 731 DUVAL STATION RD QA REX JONATHAN WILLIAMS
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.
Suggest good documentation of impervious areas.
Lot elevation cannot be raised.
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.
Slab and Driveway to be fully removed.
Full site to be grassed.
FEES:
Demolition Fee $100.00
PERMIT IS APPROVED ONLY IN ACCORDANCE: WITH ALL CITY OF ATLANTIC BEAC11 ORDINANCES AND THF: FLORIDA
BUILDING CODES.
(-:> � , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
. - . ATLANTIC BEACH,FL 32233
\ INSPECTION PHONE LINE 247-5814
0.v3 9'''
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.
�5�vik City of Atlantic Beach / ' FrtDi APPLICATION NUMBER
\J' 4' SS Building Department ) (To be assigned by the Building Department.)
r 800 Seminole Road MAY 2016 f - Q
j Atlantic Beach, Florida 32233-5445 /6 kindidea
Phone(904)247-5826 • Fax(904)247-5845
"=/011 0. E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 26 3 /2 ✓ £7 Department review required Yes No
/j Building
Applicant: Sigr, -hire, fia. ) 5 Planning &Zoning
Tree Administrator
2f14O Project: - Gc,S Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Review or Receipt r
Other Agency Review or Permit Required 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:
APPLI ATION STATUS
Reviewing Department First Review: Approved. ['Denied.
(Circle one.) Comments: / / , / /'
BUILDING 14 h ,if Ce �u l
PLANNING & ZONING Reviewed by: -- . 17. -- Date: / cc,
ADMIN. Second Review: Approved as revised. 111enied. �3�
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
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FIELD WORK DATE: 12/30/2015 REVISION DATE(S):(REV() 1/4/2016)
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1 BY, i R.L.S. NO. 5362 "� STREET —_
J s N W. WALKER 1�th�,v„—
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BEARINGS BASED ON THE NORTH LOT LINE OF LOT 35 °
SAID BEARING BEING N 74'4.0'34" E ill
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I Use of Trus Survey for Purposes other than intended,Without written Verification,will be at the User's Sole Risk and Without Liability to the Surveyor.
--_-_ -- - -_ __ Nothing hereon shall be Construed to Give ANY Rights or Benefits to Anyone Other than those Certified.
FLOOD INFORMATION: POINTS OF INTEREST
BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING NONE VISIBLE.
MUNICIPALITY OR WWW.FEMA.GOV,THE PROPERTY APPEARS TO BE
LOCATED IN ZONE X.THIS PROPERTY WAS FOUND IN THE CITY OF l__ ._ . y._ _ _ ff
JACKSONVILLE,COMMUNITY NUMBER 120077,DATED 06/03/13. J
ENT NUMBER: I_ — ��i DATE 1/4/2016 evr..,CI t;i Florida Land AFFILIATE
BUYER �� ' �.77 f = FL'-TA Title Association MEMBERS
_._______-_-- L
SELLER
i CERTIFIED TO: ---___._...__—_._.______.�__�_� � .. ,, t =-1
FL___- PLand Survevorc Inr www.exactaland.comI 1
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BUILDING PERMIT APPLICATION /c /B
A • J
CCITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233 /0
�`D'jlSfr Office:(904)247-5826 • Fax:(904)247-5845
Job Address: 63 �a� � e- Permit Number: 171. 'I j
Legal Description ( 3_) RE#
Valuation of Work(Replacement Cost) $ /1176 .60 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Mov: - memo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial 'esidential
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes 1 o N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
bemo1i�‘b'vn o$ ex`lS-k w\ r )Me.
Florida Product Approval# \ J
for multiple products use product approval form
Property Owner Information y
Name: I"'. T1 o,h.d Address: (38 Vo r k s j r e, b�;
City u c�V. StatePa. Zip L 520$ Phone
E-Mail
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required) 1K a Ka p,.w.--3
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.
Contractor Information: �. aor4 I I (
,1 VC iQ alifying Agent: 1 J i i p�v�.T
Name of Com any: i�•v�a �� 0 , S �o � � 1� 1
Address:73 I ri,>Uey {4_ 1,3... • , u, c. 1 al. 1 i City T„k State Zip\2L 31)-18
Office Phone tI 0 5 9 $r7 ob Site/Contact Number Sa C
State Certification/Registration# C'6 G-04-$Vi CE-Mail rex/,,):i v„iv.& C5-t( 3 vv,,,,,,(, c,M
Architect Name & Phone#
Engineer's Name & Phone#
Worker's Compensation
Exempt / Insurer / Lease Employees / Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installati,n has commenced
prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating constructio• this jurisdiction.
This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspende. ‘, abandoned for a
period oJ'six(6)months at any time after work is commenced. 1 understand drat separate permits must bebe secured for Elect ' Work,Plumbing,
Signs, Wells,Pools, Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc.
Signature of Property Owner: Signature of Contractor: „„�1 �!
Before me /this_Day of JIT?fLA ) Before me 'II 0 41111 6 / , TO
Notary Public: ' .0 1
No • ��
noWA/
I hereby cert that I have read and examined this apt ica and r t - ej ,. tru •nd torr provisions oflaws and
ordinances governing this type of work will be comp �h-m '.pry l.-i 10Y or ot. The grantinof a permidoes not
presume to give authority to violate or cancel the pro s o P y: , - �,t- d aegso, or 'cal law regulating construction or the
performance of construction. 9jFoi 0.d' Expires 02/14/2018
Rev.3/14/16
•
App was e Co.es: 20 ORII ABU LThNOTWffiTEEELOWOFFICEUSEONL DIN Y
Review Result (circle one l•
Approved Disapproved
Approved w/ Conditions
Review Initials/Date:
Development Size
Habitable Space Non-Habitable
Impervious area
Miscellaneous Information
Occupancy Group
Type of Construction
Number of Stories
Zoning District
Max. Occupancy Load
Fire Sprinklers Required
FIood Zone
Conditions/Comments:
si, 800 Seminole Road
0
_ Atlantic Beach,Florida 32233
_,, Telephone(904)247-5800
J FAX(904)247-5805
ArJsOtP
Construction Site Management Plan Compliance
A construction site management plan conforming to Atlantic Beach City Code Sec 6-18
has been approved as a part of this building permit. The Construction site management
plan was approved based upon the following information.
1. Parking plan—parking plan showing how site will be accessed and all onsite
and abutting street parking areas.
2. Location of construction trailers, loading/unloading area and material storage
area.
3. Location of chemical toilet area.(chemical toilets must be kept out of City
right-of-way and not further than 15 feet from structure under construction)
4. Location of dumpster. Dumpster must be from an approved waste company
(in accordance with Chapter 16 City Code)as of 2009 the permitted
dumpsters are Advanced Disposal,Realco Recycling, Republic
Services, Sunshine Recycling and Shappells. Dumpsters will have
tarp covers or rigid covers on windy days. Dumpsters must be removed prior
to issuance of Certificate of Occupancy.
5. Traffic control plan, showing access with dimensions, area to be stabilized,
narrative on phasing of construction with adequate parking and delivery of
materials.
6. Site cleanliness. Contractor must have the entire construction site cleaned by
Friday of each week. This means removal of scrap lumber,concrete remnants
and other such construction debris including cans,metal,plastic and paper.
7. Erosion and Sediment Control. Contractor must maintain all elements of the
approved Erosion& Sediment Control Plan(silt fence, catch basin filters, etc.)
until sod or other stabilization has been placed and approved by Public Works.
8. Other activities,where special conditions are identified by the Building
Official.
Failure to comply with the Construction Site Management
Ordinance may result in a Stop Work Order being issued in
accordance with City Code Sec. 6-17 (3)
Revised 3/2016
Letter of Intent
Authorized Agent
This agreement is made this AS day of_A pp -,\ _,2016 between Mike and
Sarah Hand (hereinafter referred to as owner)and Rex`J. Williams, Signature Homes&
Development, Inc. (hereinafter referred to as Contractor).
Owner agrees to use contractor for work performed on their home located at 363
12th Street, Atlantic Beach, FL, pursuant to all permitting, design completion,and final
pricing. Owner authorizes contractor to act as owner's representative on said project for
the purpose of applying for permits, variances,and engineering.
Owner: Contractor:
7714,4/ 762' 1rr' ►��
Michael Hand '7• J Williams
'ign•ture Homes and Development, Inc
Owner: )
S and
Notary:
In 1 U‘Lth GW-f)
PENNSYLVANIA
Notarial Sear
Michele A.Green,Notary PubBc
aY of Plttsburyh,Alkgheny
COnmviaton Expires Nov. S,2017
5-r1 VAKA AS$oQ . N• honu::;
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PREPARED BY: w*e
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LAND SURVEYORS 11
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PROPERTY ADDRESS:363 12TH STREET ATLANTIC BEACH,FLORIDA 32233 SURVEY NUMBER:1512.2932
FIELD WORK DATE:12/30/2015 REVISION DATE(S):(REva 1/4/2016)
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BY: I`') R.L.S. NO 5362 12th STREET
J N V. WALKER a �
BEARINGS BASED ON THE NORTH LOT LINE OF LOT 3�
SAID BEARING BEING N 74'49'34"E
the of Tnis Sulvey for Purposes other lhan Intended.Wnhot l Written Venficabon,snll be at the Users Sok Risk and Without liability to the Surveyor.
Nothing Bacon shall be Construed to Give ANY Rghts or Benefits to Anyone Other than those Certlhed.
FLOOD INFORMATION: POINTS OF INTEREST
BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING NONE VISIBLE
MUNICIPALITY OR WWW.FEMA.GOV,THE PROPERTY APPEARS TO BE
LOCATED IN ZONE X.THIS PROPERTY WAS FOUND IN THE CITY OF
JACKSONVILLE,COMMUNITY NUMBER 120077,DATED 06/03/13.
./ Florida Land AFFILIATE
CLIENT NUMBER: •DATE 1/4/2016 • =4
Title Association MEMBERS °i
BUYER:
FLTA�—
SELLER:
CERTIFIED TO:
Land Surveyors, Inc. .eaactaland<an;'
This is page 1 of 2 and is not valid without all s. Pb6,Sone .11.•
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