320 11TH ST - DEMO (10.4,1V.kriel
44"
e° � CITY OF ATLANTIC BEACH
A j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
'r2.J;1l9�
DEMOLITION PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-DEMO-1650
Job Type: DEMOLITION
Description: DEMO - HOUSE
Estimated Value: $16,230.00
Issue Date: 8/1/2016
Expiration Date: 1/28/2017
PROPERTY ADDRESS:
Address: 320 11TH ST
RE Number: 170065-0000
PROPERTY OWNER:
Name: SMYTHE ET AL, ERIK A
Address: 320 11TH ST WORHTLEY JEAN & SMYTHE CHANHOM
GENERAL CONTRACTOR INFORMATION:
Name: BURKHALTER WRECKING INC.
Address: P 0 BOX 2407 QA PETER JEROME BURKHALTER
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.
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 and Waste Pro).
Full right-of-way restoration, including sod, is required.
Strongly suggest good documentation of impervious areas be recorded.
Slab and driveway to be fully removed.
Lot elevation cannot be raised.
FEES:
I9P # n PPp :D ONLY IN ACCORDANCE:VI((- A
, CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
e 0 s f CITY OF ATLANTIC BEACH
A s) 800 SEMINOLE ROAD
mil
41 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $104.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WFTII ALL CITY OF ATLANTIC BEACH ORDINANCES AND 771E FLORIDA
BUILDING CODES.
;� ry`, CITY OF ATLANTIC BEACH
A j 800 SEMINOLE ROAD
J :". ATLANTIC BEACH, FL 32233
(904) 247-5800
. .JJ3l9'r�
PERMIT NOTES
RESIDENTIAL DEMOLITION
August 1, 2016
320 11th Street
BP # 16-DEMO-1650
1. It is the responsibility of the contractor to:
a. Contact JEA to disconnect electric power.
b. Disconnect and cap off water, sewer, and gas lines.
2. Silt fences must be in place and approved by Public Works before beginning
demolition.
3. All underground tanks, concrete slabs and foundations must be removed with the
buildings, unless otherwise approved by the City. The site should left graded and
clean for Final Inspection..
4. A water supply and hose may be required to control dust during demolition.
(Required for masonry structures and asbestos-containing materials.)
5. Removal of any trees requires a separate Tree Removal Permit, per COAB Code
Of Ordinances, Section 23-21.
6. Protection of trees and vegetation during construction is required, per COAB Code
Of Ordinances, Section 23-32.
1
ATLANTIC BEACH
SS\
At. . PERMIT RECEIPT
-11
PAID
PERMIT DESCRIPTION: DEMO - HOUSE AU6 012p16
PERMIT NUMBER: 16-DEMO-1650 CITY OF ATLANTIC BEACH
ADDRESS: 320 11TH STj\C)161
OWNER:
DATE ISSUED:
FEES DUE:
Demolition Fee $100.00
STATE DCA SURCHARGE $2.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
STATE DBPR SURCHARGE $2.00 ATLANTIC BEAC,R.32233
0801.2016 15:31:09
CREDIT CARD
Totals: $104.00 VISA SALE
CARD; XXXXXXXXXXXX3506
INVOICE 0003
SEQ n: 0003
Batch;: 000369
Approval Code: 411013
Entry Method: Manual
Mode: Online
Card Code: M
SALE AMOUNT $104,00
CUSTOMER COPY
City of Atlantic Beach APPLICATION NUMBER
. Building Department (To be assigned by the Building Department.)
st
,) 800 Seminole Road I / �� r I C 0
tyv �� Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
1'L01119%' E-mail: building-dept@coab.us Date routed: 7/2 t 1 Cp
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3Z-0 t �1 v� - - • ent review required Yes No
Applicant: BD 1<4 L..TEg W REZKt io G Pan •ng &Zoning
Tree Administrator
Project: 1,'4.. 0 ( E Emo Public Works
Public Utilities
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: pproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: ("1" ), Date: fotig 6
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. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
,sem` ,, City of Atlantic Beach """
:,�'•��, ; � Building Department ''"" •'�''�� '� '� APPLICATION NUMBER
f. = i.+, 800 Seminole Road JULg �f be assigned by the Building Department.)
�� ' �r Atlantic Beach, Florida 32233-5445 U ` ` Mi. l0 cm O _ I 6,5 0
' Phone(904)247-5826 • Fax(904)247-5845
•'''`Zonis) E-mail: building-dept@coab.us BY: I sate routed: 7/Z (. /i
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3Z� I CS S 1 • - e . ent review required Yes No
, Buildi •
Applicant: BVRK4PiL `W RE-CK(10C P an 'rig &Zoning
Tree Administrator
Project: 11/4-1 0 GIS E -0 E,AA,r ) Pub
` lic Works
�J Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
• 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. ODenied.
(Circle one.) Comments: /,
det diUa 16-
BUILDING
PLANNING &ZONING 7 %j / Y , ) / 6
Reviewed by: i 77,2- 1/
Date: l .R(/
TREE ADMIN.
Second Review: OApproved as revised. nDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. ODenied.
Comments:
Reviewed by: Date:
tevised 05/14/09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 1 , -D Gmo - I(03 0
Job Address: 320 11TH ST Permit Number:
Legal Description 5-69 16-2S-29 ATLANTIC BCH LOT 2 BLK 13 Parcel# 170065-0000
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 16,230.00 Proposed Work heated/cooled 1274 non-heated/cooled 660
Class of Work(circle one): New Addition Alteration Repair Move(Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial C.R siden ial-
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes N/A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed:DEMOLITION AND REMOVAL OF THE ONE STORY
WOOD FRAME HOUSE
Prope Owner Information: _
Name: ii 14t!' ill i' Address: 361 1 - :. ..f-
City i" '' C, WPAIIVILIE State'Zip - hone G(:)`f Malin.
E-Mail or Fax#(Optional) .C LC1..lL c't S ..."! ,: - ,
Contractor Information:
Company Name:BURKHALTER WRECKING, INC Qualifying Agent: PETER J BURKHALTER
Address:PO BOX 2407 City JACKSONVILLE State FL Zip 32203
Office Phone 904-354-7813 Job Site/Contact Number Fax#
State Certification/Registration#CGC058075
Architect Name& Phone#N/A C3 \\--) t )c(- 00+(cob. Corr\
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. 1 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 f6)months at any time after
work is commenced. 1 understand that separate permits must be secured for ElectricalPWork, Plumbing,Signs, Wells, Pools, urnaces, 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 hereby certify that 1 have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type ofwork will be complied with whether specified herein or not. The granting of a permit does not presume to give author' to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
a
Signature of Owner Alb. - - — Signature of Contract., --. 1.11:01!
1.1.1.....0.----_
Name A( I-+ Print Name PETER J BURKHALTER, PRESIDENT
Sworn to and subscribed before me Swo d . ,seri.-. be is re me
th' /Att.-Day of u . , 20 1 cc, this £tDa,if A .4.— 20 d
IlWalf
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. Notary Public 11."='rig P 'a,' '' ' •
CA ER E G.AlBERZINSKI Ili.-- •ES:October 6,2019
•••4e,:�''' Bonded Thru b Public Underwriters
Notary ubic,State of Florida " , a" Revis•. 01.26.10
My Comm.Expires Aug.1Z 2017
Commission No.FF 18952
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NOTICE OF COMMENCEMENT
State of FLORIDA Tax Folio No. 170065-0000
County of DUVAL
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: 5-69 16-2S-69 ATLANTIC BEACH LT 5 BLK 13
Address of property being improved:320 111/1ST ATLANTIC BEACH,FL 32233
General description of improvements:
Owner: 440 r'',k.0 Address: 3G1 k1i 4 i'L
3zz33
Owner's interest in site of the imp vement: FEE SIMPLE
Fee Simple Titleholder(if other than owner):
Name:
CQntractor:BURKHALTER WRECKING,INC
Address:PO BOX 2407 JACKSONVILLE,FL 32203
\
Telephone No.:904-354-7813 Fax No:EMAIL-burkhalterwreckinginc@a,,outlook.com
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY 0
Signed: Date: l b
Doc#2016167741,OR BK 17643 Page 1024, Before me this ay of?e/p�l, / , in the Countyof uval,State
Number Pages:1 Of Florida,has personally appeared Atl4N 1 i ere-4-1A,
Recorded 07/21/2016 at 02:02 PM, Notary Public at Large,State of Florida,County of Duval.
Ronnie Fussell CLERK CIRCUIT COURT DUVAL My commission expires: 2./1.1 7
COUNTY
Personally Known: "'".. or
RECORDING$10.00 Produced Identification:_
.AliBEFFLiiYSK
Notary Public,State of Florida
My Comm.Expires Aug.12,21017