1911 BEACH AVE - INTERIOR DEMO iiit
CITY OF ATLANTIC BEACH
. 0 800 SEMINOLE ROAD
vATLANTIC BEACH, FL 32233
'740;3 v% INSPECTION PHONE LINE 247-5814
DEMO - INTERIOR ONLY
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: DEMO18-0001
Description: DEMO- FLOORING, CABINETS & DRYWALL
Estimated Value: 5000
Issue Date: 1/12/2018
Expiration Date: 7/11/2018
PROPERTY ADDRESS:
Address: 1911 BEACH AVE
RE Number: 169688 0000
PROPERTY OWNER:
Name: PETER STRAATS
Address: 47 ORCHARD LN
COLTS NECK, NJ 07722
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: K.C. Services of North Florida, Inc.
Address: 12851 Southern Hill CIR
JACKSONVILLE, FL 32225
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
JAN-11-2018 14:53 From: To:6411601 Page:1'2
4e `f;. Building Permit Application Updated 12/8/i7
City of Atlantic Beach
SP
• a,u,• 8oO Seminole Road,Atlantic Beach,4 32233
/ � Phone;(904)247-5826 Fax:(�904).247-5845 •
lob Address: /1//ge f/„7//f,f gae Permit Number: /GM C)
b
" 000
Legal Description/s'f7 Q/4,/4- LD ' RE# ff /er-O2
valuation of work(Replacement Cost)S ��000 heated/Cooled SF Non-Neated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial •esidential
• If an existing structure, Is a fire sprinkler system Installed?(Circle one): Yes 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: ��,y/0o/�/o Darnel ed DPI wd/I F/oo t��N��
, Ca61 ,✓et's
Florida Product Approval U /e//fj for multiple products use product approval form
Property Owner information
Name: _c7 7 5 ,I 7' � Address: '7 o"-e1,7-/-0/
ALAJ,
city ('n/ S .t��G State 4/17- zip c292,22 Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor information /�
Name of Company: 'i S�f'�/,' 4 p/4*F /AG Qualifying Agent: ZA).4//9 T�L',„)/M
Address .42 .seu1xrt,) .1/1.(7 .1 4°/t' City p�dL.f'S /lei//e State a Zip .2.2,2 $�
Office Phone /1 hi- BY 3 -ra8'7 / lob Site/Contact Number 9D21, - 2"73-G 6"-
State Certification/Registration a (6C /3/04Q E-Mall ,ev,,cJ/e 3,2.2-6-2'
Architect Name&Phone a
Engineer's Name& Phone a
Workers Compensation G XPf i3Of
Exempt/Insurer/Lease Employees 1 Expiration Date
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 the laws regulationg
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.NOTICE:In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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.
4(../(1d7n_6?,
Slgnature of Owner or Agent) (Sig ure of Contractor
1,12rft4
',pU%tnOrrnr,,, (including contractor)
gAgg.r.04to(or affirmed)before me this . day of Signed and sworn to(or affi e• befor day of x)s�,-9tSl A.1 S� by ' "L1 .this
!c _ -1 Com!\ , ZU( ,by _
NoTxat/ ,- r7 ,
+ tStgnature of Mbtarrfi
O (Signature of Notary
� A , a
F &BLIG N a-I Personally Known OR
L sonallffown pR
rc&ida
kfident�(}ration i )Produced Identification
°off p46R���(t�dfon: �yY y?— (2'✓�-P Type of IdenttRcatlon: .,,: •• . ►1 SPERGER951
X ,„u,, MY COMMISSION ii
EXPIRES:October 6,2019
Bonded Thru Notary Public Underwriters