1644 PARK TERR W - INTER DEMO -j \1J�.
�' 14111'' \S I CITY OF ATLANTIC BEACH
fi $ ". .J 800 SEMINOLE ROAD
.7. 1, _7) 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: 17-DEMO-3381
Job Type: DEMOLITION
Description: INTERIOR DEMO
Estimated Value: $5,000.00
Issue Date: 3/3/2017
Expiration Date: 8/30/2017
PROPERTY ADDRESS:
Address: 1644 W PARK TER
RE Number: 172020-0164
PROPERTY OWNER:
Name: Gramling, Scott And KELLY
Address: 1644 Park TER
GENERAL CONTRACTOR INFORMATION:
Name: BEETREE HOMES
, CBC1251544
Address: 13751 SAXON LAKE DR KATRINA HOSEA
Phone: 904-631-6810
PERMIT INFORMATION:
FEES: -------------
STATE DCA SURCHARGE $2.00
Demolition Fee $102.00
STATE DBPR SURCHARGE $2.00
Total Payments: $106.00
1
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TIlE FLORIDA
BUILDING CODES.
I
• t_.tr'" BUILDING PERMIT APPLICATION
�S r
CITY OF ATLANTIC BEACH
1 800 Seminole Road,Atlantic Beach FL 32233
tf_°e;tOr Office:(904)247-5826 • Fax:(904)247-5845
1
Job Address: 16 ``f Aie qC
TtR-� 6- W Permit Number:
Legal Description L 0T 11(o 010 1 i- Co set.iA MAR ii'-1 A it-% RE# 1 7 oL o D - o I (o 4
Valuation of Work(Replacement Cost)$ S000 lieated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No 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: ?Eiviovia,— of ?t--reg"D►t. ViNtstits,GPe4►ECT', Floortiub•
��MD A,-+d NoN I-opo 5ee..11 O. L..42.4...1--
Florida Product Approval # for multiple products use product approval font,
Property Owner Information
Name: Sco Tr d KEL-Ly ei2i I;tJ U Address: 1 ('44 -?,0,- K e g.a A Le. t i,
City Pal-Ai-ATI L 43eAt.pi State liZip `3:.Q Phone 9a'1-6117-9 5-87
E-Mail K Q.11 G@ th mi.dot o, 1-4Cr
t
Owner or Agen 'Alt Agent,Power of Attorney or Agency Letter Required)
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:
Name of Company: �j, E EaI .L. U -?, 3"/-,c,1 Qualifying Agent: 14 Arg;4rIfic, Ho-11..A -
Address: 1 33 4'; AT2.A r i(- 6.)irD City 'DAuc sore diW- State Zip RI ' DVa5
Office Phone '51 G -4 t o a Job Site/Contact Number 9 011- G 31 ,-4 6 10
State Certification/Registration# 1 a51 ;4-I 4 E-Mail See-rem", i%Nra Q r OA s (---DM
Architect Name& Phone#
Engineer's Name&Phone#
Worker's Compensation
Exempt [insurer I Lease Employees / Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated. I coll.&that no work or installation has commenced
int-tor to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating constructi,n in this jurisdiction.
Tltis permit becomes null and void ' work is not commenced within six(6)months. or i(construction or work is suspen.,d or abandoned for a
period oI'sir(6)months at any time after work is commenced. 1 understad that separate permits must be secs -ed for lite,,teal N ork,Plumbing,
SRR
,Signs, 'ells,Pools,Furnaces,Boilers,Heaters,Tanks and Air Conditioners,etc 1
Signature of Property Own • Q Signature of Contracts / `t _____, __
Before me l A
this Za Day of F�6 Before me thi. _•••_,', F� j:-N-'7''RGUSON
41:t eik, JOHN L FERGUSON MY COMMISSION#FF197554
••= MY COMMISSION#FF197554 1. '
Notary Public:__ r Notary Public __ tmt, • _ EXPIRES February 09,2019.
.., EXPIRES February 09,2019 14C/13960•bl
14C1131►Esav►e..oa�
-0'53 flocid•NotarySKMo..co
1 herein.certify that 1 hr li c s. ,l n.,fJ,�{�ut,;ni rt r,,,;and know the same to be In le 'n , , n . . 11 t.
ordinances governingthis.t • I/x tri ;11 t ,I1, +d,h xhether s ect/fed herein or n . tr rnrin> d a •rn;rt tG � not
profane to ive authrity to . l! tars l , ',7,.,',7`�'i)Tr',�bnt'other fcaera! .state, or h cal law veulat 17 jl non or tl;.•
performance of tonut•uctir, ?Ail/ tRe
7 Rev.3/14/16