1519 JORDAN ST - DEMO ?S�"Ly�✓
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
t ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
.1'.40.1111P
DEMOLITION PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-DEMO-1355
Job Type: DEMOLITION
Description: DEMO - HOUSE AND ALL CONCRETE PADS
Estimated Value: $10,000.00
Issue Date: 6/20/2016
Expiration Date: 12/17/2016
PROPERTY ADDRESS:
Address: 1519 JORDAN ST
RE Number: 172297-0000
PROPERTY OWNER:
Name: BEACHES HABITAT
Address: PO BOX 50939 JACKSONVILLE BEACH
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.
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.
Lot elevation cannot be raised.
FEES:
Demolition Fee $100.00
iSTATIErOZAWARCMARGEtcconDANcES2140 nI.I, (I'I'IN OF I,ANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
:r
Jv,
�� CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
to ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
i J331!?
STATE DBPR SURCHARGE $2.00
Total Payments: $104.00
PERMIT IS APPROVED ON IA IN Al(ORD:AN(:I 111111 :U.1. CrIN Or ATI.. NII(' Iw&(:II ORDINANCES :ANI) TILE FLORIDA
BUII.DI\c CoII:s.
r - Jr) City of Atlantic Beach APPLICATION NUMBER
t-j 16Buildin Department JUN L
(To be assigned by the BuildingDepartment.)
)7r0 - 800 Seminole Road a 1016
Atlantic Beach, Florida 32233-5445, ^ ` G- DE.A10
Phone(904)247-5826 • Fax(904)24 -
\ gm9'f- E-mail: building-dept@coab.us Date routed: 6
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:1 5 n OrC1Ccn, S T Department review required Yes No
Building
Applicant: :Ae_ s 146 Q` rcc Planning &Zoning
Tree Administrator
Project: EMp — OSE rA� Public Works
r Puu iic Utilities
��- C)Y s 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: i4proved. ['Denied.
(Circle one.) Comments: let/ t 4 /
GG� GpNIXZ,e4
BUILDING
PLANNING &ZONING
Reviewed by: ` Date: 6/
TREE ADMIN.
Second Review: DApproved as revised. I%enied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ODenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
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G� A90
.. BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
i3,00 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 —p SM0-1 355
Job Address: JSj Qi -3-......t....._ 5-1- Permit Number: 11 -Z29 7 - o600
Legal Description oil; —S Z) 17 - �.
a9 . i t LA 5wti-PL. ?I) Parcel # h/- art. 2z La-�
Fr `42,
Floor Area of Sq.Ft. Sq.Ft 5 . t c..7 41 fr 3
Valuation of Work$ /d., o 44 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Mov/Demoli ,n.' pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial •sidenti.
If an existing structure, is a fire spri1'.nkler system installed? (Circle one): es Jt! N/A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: Jt r to I.4-e u_,k 1 5.•1v i..(,.:.1— '11 ..,q.)
5'a . ,-t; 1 417_ bbr'he
Property Owner Information:
Name: geswk.s 1' it. i.4- . .r01Aw1c44-{Address: 1 S 1 141.0tAp-4- til.
City 44-/g,,,,Re_ ifoLc Stated Zip 32433 Phone 9 ( .).Y t- r.2-1..Z
E-Mail or Fax#(Optional) log- 'Nixie - 44 31 o A.."
Contractor Information: CONTRACTOR EMAIL ADDRESS: r' ieff-e,✓5 rr--‘ [" 1 rc c ,e s 1.4.4;4,4-,e,_a
Company Name. (9,,,cttt„e5 1 .4 cts.,7 «�;4- qualifying Agent: Q4 e4- -kers,,-,
Address: -701 7 1M cy r} PA, City ig r/ & *6.1, State '=/ Zip 3Z�3�
Office Phone y t ' 1 42.. Job Site/Contact Number 33q- / 2-0 Fax# V 1- i /".0
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 ofa 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 BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I herebycertify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type ofworkwill be plied 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 othe ederal,state, or local law regulating construction or the performance of construction.
Signature of Owner \ •Siof Contractor w" -, AP-f
Print Name 0 i2-12 :� o.,,e '5 Print Name \24.-N, )• re 4-e i
Before
'
this 1Day of 5t,.�.` I to Before }e ay of Sse_ , 201 L
‘/��y _.
Notary Publi ;rL. Y 4 , a. :' ,Public KW. MURRAY �—
Notary Public•Slate of Florida ' ':6 Notary Public.State of Florida
• • Commission+►FF 941141 + • •i Commission#FF 941841 R; ised 01.26.10
:,;. My Comm.Expires Apr 2,2020 --...--14r My Comm.Expires Apr 2,2020
*'nt• Bonded through National Non,Assn. 4 •.�1i!:..:la`�� nem./1 tMn.onA u.ttwwel LW....•...
TREE & VEGETATION REMOVAL PERMIT APPLICATION
INSTRUCTIONS .a.A% City of Atlantic Beach
(1) Complete and sign this form. 0° Department of Community Development
` 800 Seminole Road Atlantic Beach,FL 32233
(2) Attach the required supporting exhibits as listed on the application e °
checklist. , . (P)904 247-5800 (F)904 247-5845
(3) Contact the Department of Community Development if you have
questions or need assistance completing the application orSingle /Two Family Residential $125.00
determining which exhibits are required for your particular project. , f Multi-Family Residential $250.00
(4) Submit this form, along with all required exhibits and payment to
the City of Atlantic Beach,and in the appropriate amount according r Commercial/Industrial $250.00
to the application fees listed to the right, to the reception desk at fl Institutional/Other Non-residential $250.00
the Building Department.
Application#TREE
SECTION I-SITE INFORMATION
PHYSICAL ADDRESS /c 9 �o�d(,a� c)-t- . C.o ^,/T. a
32-2.33
If an address has not been assigned to this property,contact the AB ft�uilding De artme t at(904)247-5826 to request an address.
Nr3`lsz ff- to'rZ
SUBDIVISION BLOCK tit
SM. It 3 LOT - 14 LyeE# n -).--1-417- 0 Go
0
SECTION II-APPLICANT INFORMATION
�bWNER r LEGAL AUTHORIZED AGENT*
NAME OF APPLICANT tte f (4-sth -r-crr Irk A/�
ADDRESS OF APPLICANT -p - od,Ap�r,4„ Q.t., C.-D. A, 3-
PHONE q 64/,. 1.41 -,t1 ELL in t(„ 33V— J . Z EMAIL -Fe,rf6v� 1,{rcc ve ,f
P � s ti
SECTION III-TREE&VEGETATION REMOVAL REQUEST v 11._
I REQUEST THAT THE TREES&VEGETATION ON THE ABOVE DESCRIBED PROPERTY AND INDICATED ON THE ATTACHED REQUIRED
EXHIBITS BE APPROVED FOR REMOVAL,AS PROVIDED IN THE CITY OF ATLANTIC BEACH VEGETATION CODE,CHAPTER 23, FOR THE
FOLLOWING REASONS(check all that apply):
fl Vegetation(trees)are difficult to maintain/owner dislikes.
✓ Trees are dead,diseased or so weakened by age,storm,fire,or other injury so as to pose a danger to persons,property,
improvements or other trees.
✓ Vegetation(trees) pose a safety hazard to pedestrian or vehicular traffic or cause disruption to public utility services.
Vegetation(trees)pose a safety hazard to buildings or structures.
(X% Vegetation(trees)completely prevent access or cross access to a lot or parcel.
1Vegetation and/or trees prevent development or physical use. It is the intent of this provision that a permit shall be granted for
C the removal of vegetation and/or trees when the applicant has demonstrated an effort to design or locate the proposed
improvements so as to minimize the removal of vegetation and/or trees.
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED WITHIN THIS APPLICATION IS CORRECT AND I AGREE TO COMPLY
WITH ALL PROVISIONS OF CHAPTER 23,PROTECTION OF TREES AND NATURAL VEGETATION,AND ALL OTHER APPLICABLE
CODES AND ORDINA► ES-. E CITY OF ATLANTIC BEACH.
6,7-2-7/ L
SIGNATURE OF APPLICANT DATE
!FOR INTERNAL OFFICE USE ONLY
FRONTAGE FLU NAR ESA
SR-1
!DEPTH ZONING UBEX
H/H SR-2
i AREA ISA WAN
OAB CR
Tree&Vegetation Removal Permit Application_versionor.ol.og
i
EXHIBIT A. LETTER OF AUTHORIZATION
DRTV 10- •
RAI,*Y 1�-�AhcYs�v`r {. :y^.-y_...4-4is hereby authorized to act on behalf of
3+ac4.ts 11,8.1 ;-6.41�1,..4,,�;411,
the owner(s) of those lands described within
the attached application,and as described in the attached deed or other such proof of ownership as may
be required by the City of Atlantic Beach in applying for a development permit.
BY: l Si
Signat Of Owner or O ner' Legal Representative
--iPrinted ame
iQi r U . eeJ.., Ft 3223-3
Mailing Address
q0111- 11 .5/Tiibil2fAi
-5/
3,C.irftte-3;
Phone Cell x mai ,C1---F
,Aif"nem@ case tj0da t •a r
3
State of: �L
r
County of: ``
IJV VA,
• Signed and sworn before me on this day of �" ?�� by
l.)4-1,1); c Sbi s
Identification verified: 77
L-✓r7,g1.-. 1 � w L
,o
Oath sworn: 0
[- Yes (�jNo
Notary Signature _
My Commission expires: ""u% KYLE MURRAY
ari.1 COMM*/Mt MINI
.,44�' COMIC 610.11 AIN:,ZOlO
INN NINO .
�' — EXHIBIT A_Letter ofAuthorization_vo5.io.io
SI EXHIBIT B. TREE &VEGETATION INVENTORY Application#TREE
For the removal of 25 trees or less associated with major development, redevelopment or renovation of or addition to single-
family or two-family structures,or the removal of 25 trees or less associated with the renovation of or addition to all other non-
residential uses,use the grid below to create a Tree&Vegetation Inventory. Note the scale on the bottom of the page. Plot the
boundaries of the subject property,as well as existing and proposed structure(s). Label all adjacent streets. Note the location of
trees to be removed with an"X". Note the location of trees to be preserved with"
(mitigation) trees with "O". Number all trees, whether to be roved ( ) Note the proposed locntEX B replacement
m
Vegetation Mitigation Worksheet. , preserved or replaced, and list on EXHIBIT C. Tree &
mu ________ ._ illIII III11111111111111111111111111111—■
NE mill 11111111
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lins111111.11111111111NI III
III
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III
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PREPARED BY:
--\Z..01Q v� I•c e"\ -het< S t.e-tft-V SCALE: 1 SQUARE_
a.. rcL ot.
----- ____ EXHIBIT BTree&Vegetation lnventory_version 01.01.09
,r
EXHIBIT C. TREE VEGETATION MITIGATION WORKSHEET
Application#TREE
O'B :COMPUTED BY " ,APPL` '` „ 0, COMPLETED BY CITY STAFF
ID DIM SPECIES CONDITION I —
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( ` EXHIBIT C. TREE VEGETATION MITIGATION WORKSHEET
Application#TREE_-
TO BE COMPLETED BY "E'. f�.,- '..�
:^FF
ID DBFI. ,.., SPECIES CONDITI o.,;
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TOTAL
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