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1927 BEACH AVE - DEMO , 4pr ` `'�1\ CITY OF ATLANTIC BEACH J 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-1763 Job Type: DEMOLITION Description: demolishing single-family home & existing pool to build new single-family home Estimated Value: $29,460.00 Issue Date: 9/1/2016 Expiration Date: 2/28/2017 PROPERTY ADDRESS: Address: 1927 BEACH AVE RE Number: 1696.91-0000 PROPERTY OWNER: Name: TOVEY, KIRK A Address: 13751 CLUB COVE DR GENERAL CONTRACTOR INFORMATION: Name: GBN CONSTRUCTION, INC. , CGCA12061 Address: 6054 -8 AR ARLINGTON EXPRSY BRADEN J NEGAARD 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, Sunshine Recycling and Waste Pro). Full right-of-way restoration, including sod, is required. Strongly suggest thorough documentation of impervious areas be recorded. Slab and driveway to be fully removed. FEES: I b Ftiorfrae ;D ONLY IN ACCORDANCE$1010.Q0. CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. (1-41'Aj‘ ;.' 10 •S� CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD . ,..... :II, r� ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 STATE DCA SURCHARGE $2.96 STATE DBPR SURCHARGE $2.96 Total Payments: $105.92 PERMIT IS APPROVED ONLY IN ACCORDANCE: WWI ALL (II'V OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. r �ar�;. City of Atlantic Beach APPLICATION NUMBER (---- 1 • Building Department (To be assigned by the Building Department.) t >-='G ``v 800 Seminole Road nnLL ' �1 - Atlantic Beach, Florida 32233-5445 1(O— £f 4 0 — �1 (a 3 ,` Phone(904)247-5826 • Fax(904)247-5845 r— ",;;19r E-mail: building-dept@coab.us Date routed: b RI 01 I 1 1u City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: _ 1 a 4 h Q.• Department review required Yes No Building Applicant: gt gl' e.0 flS I tA( ti-) Planning &Zoning �" dS� Tree Administrator ■■ Project: �(�0 l� Q. � - rlt(n��� (llc)N��. � � Works Lt. (NO, POD1 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 J f� 176-r�M ( -� IA 0 TC� PLANNING &ZONING Reviewed by: - 4‘--- Date: (54 6 TREE ADMIN. Second Review: ['Approved as revised. ['Denied. 1111 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 iy 1;_ City of Atlantic Beach APPLICATION NUMBER o �' -' To be assigned bythe BuildingDepartment.) �� Building Department ( g p ) .--. `i 800 Seminole Road 0— ,b6,40 – i� (Q 3 6141':''', -••- r Atlantic Beach, Florida 32233-5445 A r I r– \ Phone (904)247-5826 • Fax(904) 2 845�UG C 1Qrs Date routed: (��SI ` 1� ' p;il>i- E-mail: building-dept@coab.us City web-site: http://www.coab.us BY , APPLICATION REVIEW AND T ACKING FORM Property Address: 1 a 4 N- IA MI t• Department review required Yes No _ 1 Building - Applicant: Applicant: g/\) e.,0f1St<<Jl .A3il Planning &Zoning Tree Administrator Project: d-t 'O r\ 112. - Frtinmt. KO/At 41 Public Works Public Utilities no, p00\ Public Safety Fire Services Review fee $ Dept Signature I 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: ✓proved. (Denied. (Circle one.) Comments: ,1,i 00 41 6Pide BUILDING / PLANNING &ZONING Reviewed by: La/Le Dater//Z/a NI TREE ADMIN. Second Review: I '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 ia2 lw 444- ice6e7r ffmtpQ dl r az/711 3I.!' 2y q�'fi � y .61,441441 � izb --- - Fa(llvr.t it/l(32- /312- __>4•12 Alas -7- /(10 w 200'. r/4 : Gththiciii47, ce? 342 4 r iVd - 3 , l -(42-, Waal K s6 t CITY OF ATLANTIC BEACH 1s1 it is 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 (904) 247-5800 • 4-0i31 PERMIT NOTES RESIDENTIAL DEMOLITION August 23, 2016 1927 Beach Ave. BP # 16-DEMO-1763 14% 1. It is the responsibility of the contractor to: -`' ►7 C r a. Contact JEA to disconnect electric power. �/® capoff water, sewer, and gas lines. b. Disconnect and 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.) 0 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. 7. Prior permission from the Building Department is required before blocking any part of the Right-Of-Way. 1 i, ATLANTIC BEACH BUILDING DEPT. $34� - r, DEMOLITION - PROPERTY OWNER k� RELEASE FORM 0 �Jii opy) 0. Date: . /f///6' To Whom It May Concern: I /We the current property owners of: Lot vac. Block '►X10r Ih /) ( tc.- ,-tc_, 4ge_ac�. , Lt 1,4' a ,,?? ��11 Legal Description of Property AKA (° o--7 1J e a c-1-1rt'i e-h uee ` 3 -Z.3 3 have contracted with to have ► II (Address of Property) I� C �J Col S 4-nA-64--(c) ` ,c, to remove the s lt\� I Fa ,,L 1_ (4-crl (Company Name) (Single mily,Duplex,Commerc 1,etc.) i Prior to the construction of: R ✓te,w 5i 11 arm y --VCI , As a condition of issuing the permit we agree to the following: 1. All utilities are to be located and clearly marked. 2. Once house is removed, lot is to be graded and leveled. 3. All construction debris is to be removed from the property. 4. Affected area is to have grass or seed in place. 5. Erosion control devices will be put in place and will remain in place until grass has covered affected area or new structure is completed and landscaping is in place. ECS>d-•--- 5c/� v .10 �i�2-r ir- CLA-4_.-Signa a ,J- i �Q� /I .cl!T �-fftilj�Y Signatur /ek QCT &027C/ �e1T / ..,c.. cc,/ THIS SPACE FOR RECORDER'S USE ONLY 0 OWNER / / Signed: J h 7-2-:0,, Date: Q�",//(--i Before me this 3 day of l ()5u S4- in the County of Duval,State Of Florida,has personally appeared Notary Public at Large,State of Florida,County of Duval. My commission expires: --Ta., `l,SOI g- rsonally Knowr� or roducend'ntification: /1/ OF ' AM - . LORI JANE MEROLLE �l'.•.::7,„ LORI Commission u Fl 146413 I' My C ` % 111 rn oet ssIon E xj),,t-t, '''f..,;,` July 29, 2018 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax(904)247-5845 Job Address: / / a? 6 & - c LIlre-n u_e Permit Number: l(0- i €MO"- 11(03 Legal Description Lof. 672.r N0 t- lcw--;c f3 Q.a.r,G, (,(h i f a Parcel# /6 `16 9 / D a 0 0 / Floor Area of Si Ft. Sq.Ft / 7f Valuation of Work$ 2O Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move olition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial I:- ..ential . If an existing structure,is a fire sprinkler system installed? (Circle one): Yes o CN/A:.) Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed:' e►�o t t s �,.ir•q e- $11-N1(e -G,rv,,i ly v.e tv, e re,...4--a.-7-i v v, 40 L c,1.i lc! cL rre i s l \r`Q (.c -(-,,,,,,,,,it ko fry.... iuv�.rltcjGc 1Z.crnpthm- ©v �i�l.1-+Tlt.s4 5 t ii) 71d J4 P 6, _ Property Owner Information: Name: KlY i< + ka.ret.�o v 84.i Address: (3 8 ci 8 3 eAl0. Riva_ Larva City 1 a.c.acs o)..V i( StatetLZip 3 2 2 ZS-Phone 9 O q- .p..0 - 8300 E-Mail or Fax#(Optional) k o v e1, a -o va ScA.Y i ca.I. ri¢.,-i- Contractor Information: h,0.l 1 0f.ci,, @ 3/3 r\ GonS"{'►z`cilV h . 11ei- Company Name: C7 l3'N Co hs- i-u..cfi o 1-, 1 ►'.G. Qualifying Agent: 13 Yot.d eh. q Qr N e aci Address: (90$7[-s AvIir '/ah Gkpr-e.ssway cityTo,c.kso kv j (Le State tL ' Zip 322-61 Office Phone 010 41- a.S" - 338Job Site/Contact'Number 4Q t(-76/13- Q.6 70 Fax# 165i- -7a1- sae-g State Certification/Registration# C C.9 l Zo 6 I Architect Name&Phone# k e v it- ( -°Ly t3 t s 6 r, C rn(-10 Ct 0 4f- 3 7 a.- q $a Engineer's Name&Phone# LO UL P6 r.`t'i9 0 -4- 7`�ss o c, q o(/- a 4l o�- 090e Fee Simple Title Holder Name and Address K. r Ig. -t- ie-et.1-e4._ `7ov 7 Bonding Company Name and Address No / Mortgage Lender Name and Address Nip_ t t.t�A.oJ eq-4 �1cs6 C iN c c, ,�,u cc-volts- .NIL-o F le1/41 xc -- L_b s 'P /S21X14 Fc -fr U f coxlSZ2tse tt N 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 per ormed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void of work is not commenced within six(6)months,or if construction or work is suspended or abandoned for a penod 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. 'hreby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this ypeof 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 'rovisions of any other federal, tate, or local law regulating construction or the performance of construction. foxie- /O l,— ;ignature of Own a ,%.1111111r ! - `°c-- Signature of Contractor ,/ j ie i,...40 'rint Name /,7y21414) N6,4-APrint Name e eadif766 worn t.9 and subsc ii•ed befpre me Sworn to and subsc ' befor me his3 D/ of &iu (At- / 201 C this 3' D., of .iii TuS ,20/ , , %� •� 'gi. EROLtE _ ������ f0 public 27..p .-1. Commission A f `-�.� „� 14- 0:14 • s�� r.? My Commission E,puk:s ' N '�.- • v sion p FF 146413 I :'�an4�.° July 29, 2018 ,.�,1,10w My •mm ssIon E a iii.:s I1'evised 01.26.10 rie�� �Fm na�S. 1 ,, LL ,,, July 29, 2018 .,,SSI• ., J i ' - A', \ CITY OF ATLANTIC BEACH OWNER/ BUILDER AFFIDAVIT OB J'" y I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRU• ION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY ICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPT , TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPS' " ,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICE. E. YOU MUST z SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IM' •OVE A ONE—OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU M• ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR ESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUI FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOU': LF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL P'1 SUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH IS IN VIOL• • OF IS . EMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOU: ONTRACTO'. OUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUI • G CODES AND ONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MA . SURE THAT PEO'it EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STAT•. LAW AND BY Cs • Y OR MUNICIPAL LICENSING ORDINANCES. II. INJURY LIABILITY; SINCE 0 NERS. • BE LIA: E FO" INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTM T SU 'fir. •RKER'• COMPENSATION INSURANCE BE PURCHASED. III. IRS WITHHOLDING; • ERS HIRIN e •RKERS :ECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHO •ING T AND/0' ORM 1 0:9 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMP' OVEMEN D' . IV. PENALTY; UNLI ENS CO. RACTO'S CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OW ERS BEI G BJEC 0 $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN"OCCU. •TIONAL LI' NSE" NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "• RTIFIC' • COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCE' t N A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247--: .)IF IN DOUBT. V.ACKNOWLEDGEMENT;I • REBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I OMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERM! '. Go sir-6'. A ir561, Exp swa7 cloy-7 ar -3 3 R ADDRESS PHONE NUMBER erz►AID _ d, K -��i4A,2f PRINT AME 14M1111. , • 0A0/ 7, SI= RE DATE :efore me, is day of 41.1 U s+ 20�b in the county of Duval,S e of Florida,has personally a peared herin by himself/herself and affirms that all stat: ents and declarations are true and accurate. No- Public at Large,State of FI, ,County of tU V Pf L ' Personally Known AV'',, LORI JANE ME R O l l E Produced Identification- � ... ..`,. Commission a FF 140413 ,1ij;tis My Commission Euprn:ts Notary Signature: r �,e114 ::-,• 'r`. . July 29, 2018 . 'nuna•" F:/BIDG/Owner-Builds Affidavit;REVA E6,4/162009