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314 12TH ST - DEMO (41 *Nb t;sl CITY OF ATLANTIC BEACH 5 A S) 800 SEMINOLE ROAD j -; 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-1166 Job Type: DEMOLITION Description: DEMP - HOUSE, POOL, GAZEBO AND DRIVEWAY Estimated Value: $19,725.00 Issue Date: 5/24/2016 Expiration Date: 11/20/2016 PROPERTY ADDRESS: Address: 314 12TH ST RE Number: 171924-0000 PROPERTY OWNER: Name: GOLDKNOPF, JOSHUA & LESLIE, * Address: 314 12TH ST GENERAL CONTRACTOR INFORMATION: Name: BURKHALTER WRECKING INC. Address: P 0 BOX 2407 QA PETER JEROME BURKHALTER Phone: - - PERMIT INFORMATION: PUBLIC WORKS: 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. 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. �f (/Z� Full site to be grassed after demo. 9v� l//z -° Cannot raise lot elevation. FEES: riiiiTIEIFWAtS CkiWZG accoRDANCE WIZ ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA BUILDING CODES. A CITY OF ATLANTIC BEACH ) 800 SEMINOLE ROAD • `r ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Demolition Fee $100.00 STATE DBPR SURCHARGE $2.23 Total Payments: $104.46 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. C 1.Vi City of Atlantic Beach11: 7.Eiri APPLICATION NUMBER NBuilding Department CL`� (To be assigned by the Building Department.) 800SeminoleRoad /�� - -r Atlantic Beach, Florida 32233-5445 MAY 2 0 2016 l I— V " 1 IGC, , Phone(904)247-5826 • Fax(904)247-5845 C •�iti9r E-mail: building-dept@coab.us I ;� Date routed: J ZO i�j City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address3 4 ( Z. J ( Department review required Yes No ( Building Applicant: .)RKI tat E A-1 E.0 ( T Planning &Zoning Tree Administrator Project: E(Y\Q - kt{)t _ ublic orks_) ,D / _Public Utilities, I C7 C7 I- (- 2\ V E`iV A Lf' Public Safety Fire Services Review fee $ 2r Dept Signature lCl"...„ • 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: APP -ATION STATUS Reviewing Department First Review: MApproved. ['Denied. (Circle one.) Comments: BUILDING PLANNING &ZONINGp, Reviewed by: et . �11'`'x' Date: Zoll TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. �' IC WO-KS Comments: /V/. P S- UTILITIES I(o PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 (cLM City of Atlantic Beach RCkI�7ED APPLICATION NUMBER Building Department..�i •y�`� 800 Seminole (To be assigned by the Building Department.) r ,', r1 Road MAY 2 0 2016 � 6`� U� I l G L, ��.._ Atlantic Beach, Florida 32233-5445\. Phone(904)247-5826 • Fax(904)24 $4,,5 Y \o;si. E-mail: building-dept@coab.us = Date routed: J zQ/f'Ci City web-site: http://www.coab.us r APPLICATION REVIEW AND TRACKING FORM Property Address3\4 Z - ( Department review required Yes No Building Applicant: V ` VLl tN Planning &Zoning Tree Administrator Project: �(\/\0 _ (*p l? (; ublic Ctrl) 7i ,Public Utilities I ©0 C- ; IT V Elm F\ �� 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: rApproved. ❑Denied. (Circle one.) Comments: fee � BUILDING /A14644 (//'��� �H9U� PLANNING &ZONING //� " / / '-/2-3 Reviewed by: Date: /(6 TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑D.ied. 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 G „... 60 g”. C./.....''s? faCG� L �G� �p.G. 4 �2f� ,, goo'° F Al 77 /8''3¢ ,. ("0 — �,� v /7• ..� Nk Fr I\ kNyl N lk .1' . WI ad3¢ 1 /e Z k; •7. NX52 �� ° .t.o th / 77-`.G''- ^ -I \'• \ ..) , ,,,,,c C 5/SI.i c �' iYI'� , /G G J "a o % .7, o %. O . eN d� 0 le.v \ 8�n. — 17 CIT gROVED BUILDING NTIC BEACH OFF7CE i L U,Je r, I c 4e i i BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office(904)247-5826 Fax (904) 247-5845 Job Address: 314 12TH ST ATLANTIC BEACH Permit Number: Legal Description 23-4 26-2S-29E SELVA MARINA UNIT 1 LOT 2 BLK 2 Parcel# 171924-0000 Floor loo Area of s .r�t. S .rt Valuation of Work$19,725.002328 Proposed Work heated/cooled 2328 non-heated/cooled 1641 Class of Work(circle one): New Addition Alteration Repair Move Demolition 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): • - ' + N/A/A Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be erformed:DEMOLISH ONE STORY WOOD FRAME HOUSE, GAZEBO, POOL& DRIVEWAY INCLUDING BACKFILL OF POOL Pro er Owner Information: Name: qtr, (pt l S Address: l 4 P co P-17 Key" l PWM cS�`- City _Ta( t 11 Q State V\Zip 3�.D2Lj Phone °l64 59. 'jt). U E-Mail or Fax#(Optional) Contractor Information: Company Name:BURKHALTER WRECKING, INS Qualifying Agent: PETER J BURKHALTER Address:PO BOX 2407 City JACKSONVILLE State FL Zip 32203 Office Phone 904-354-7813 Job Site/Contact Number 904-982-4250 EMAILburkhalterwreckinginc�7a.outlook.com State Certification/Registration# CGC058075 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,Heaers, 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 plication and know the same to be true and correct. All provisions of laws and ordinances governing this type olwork will be complied with whether specified herein or not. The granting of a permit does not presume to gave . ity to violate or cancel the provisions of any other federal,state,or local law regulating construction or the performance of construction. IMP 6GAD, _�,-0 Signature of Owner • j)._ Signature of Contractor Print NameR1 .0.CoQ .e5. Print NamePETER J BURKHALTER Swo o and subscribed be ore mesub; r� Swo .�• . d � ;t o before me th ( Day of M c..,, ,2016 this 1 s ay o' : Q 2016 1 I tary Public otary u tc !� �. PAY rr,, Notary Public State of Florida ;w:: TONT GINDLESPERGER �1 Joshua Crater ..0k, ,., MY COMMISSION FF 92495: 1Sed 01'26'l U y c �o� My Commission FF 224924 ,:,r°'-r,? EXPIRES:October 6,2019 *?pf,d' Expires 04/28/2019 '•?;' 'd•' Bonded Thru No; Public Underwriters 8..,t4, ary