158 16th St-Demo permit 1i -
„ rLy s� CITY OF ATLANTIC BEACH
. i. , 800 SEMINOLE ROAD
\u V _____2 ATLANTIC BEACH, FL 32233
0;319%' INSPECTION PHONE LINE 247-5814
DEMO - COMPLETE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: DEMO18-0003
Description: DEMO
Estimated Value: 10000
Issue Date: 2/27/2018
Expiration Date: 8/26/2018
PROPERTY ADDRESS:
Address: 158 16TH ST
RE Number: 171879 0000
PROPERTY OWNER:
Name: OSSI CONTRACTING LLC
Address: 1112 3RD ST STE 4
NEPTUNE BEACH, FL 32266
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: OSSI CONTRACTING LLC
Address: 13349 STONE POND DR JACK OSSI JR
JACKSONVILLE, FL 32224
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.
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.
* 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.
City of Atlantic Beach APPLICATION NUMBER
\•a Building Department (To be assigned by the Building Department.)
800 Seminole Road n
� -,- Atlantic Beach, Florida 32233-5445 t+ l `�n`� OO
0-3
Phone(904)247-5826 • Fax(904)247-5845 / / (�
E-mail: building-dept@coab.us Date routed: 4 / i
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I5 (p� �� D9._parent review required Yes/ No
uildin
Applicant: 0 SS ( 101��(� pfC'i-bcC\
Planning &Zoning
Tree Administrator
Project: IC�v� QpPaElic Works)
ublic 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: proved, nDenied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING 'M n
Reviewed by: / , oc Date:2—G -.2evg-
TREE ADMIN. Second Review: NrApproved as revised. ❑Denied. ['Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:?/2 3/20/69—
FIRE
,1201 "FIRE SERVICES Third Review: ['Approved as revised. ❑Deni d. Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
1
r ��� i it CITY OF ATLANTIC BEACH
, j
FEB 1 3 2018 800 Seminole Road
Atlantic Beach, Florida 32233
J
REVISION REQUEST /CORRECTIONS TO PLAN REVIEW COMMENTS
Pc."), 0 —I f Jot
Date 2 1.? I k' Revision to Issued Permit Corrections to Comments Permit#
Project Address I ST i ri 5-if t_ --(-
Contractor/Contact Name 0 55: n ki ./h G L J QQ5.`
Phone 9 v y —(0 /0 -3/9 5 Email I'17,4 c.,S '),' d Fliirlr �o�u►,
Description of Proposed Revision/Corrections: Permit Fee Due $
- pc M oQ1A C)tO , /9L--) ( /7/
4.,,,.,.
Additional Increase in Building Value $ Additional S.F.
By signing below,I v l S affirm the Revision is inclusive of the proposed changes.
((printed name) r.3)7/ 3"
Signature of C'i ..(or/Agent(Contractor must sign if increase in valuation) Date
(Office Use Only)
Approved Denied Not Applicable to Department
Revision/Plan Review Comments
Department Review Required:
(-Bui inq
Planning & Zoning Reviewed By
Tree Administrator
PublicV o R
blic Utilitie
Public Safety Date
Fire Services
o.,,vi , City of Atlantic Beach APPLICATION NUMBER
�S �� Building Department (To be assigned by the Building Department.)
` 800 Seminole Road C E I V 'r, D f-Gnn D 4: _ 000-3
,, , Atlantic Beach, Florida 32233-5445 DEAD
Phone(904)247-5826 • Fax(904) 247-W45 II
01119%- E-mail: building-dept@coab.us R°,: FEB 01 1_Q1R Date routed: 6
City web-site: http://www.coab.us 0 g
APPLICATION REVIEW-AND TRACKING FORM
Property Address: LS C� ( 4__
De ent review required Yes No
p Y uildin
Applicant: 0 s5 ( P-01\-- re__A-C:r(k-
Planning &Zoning
Tree Administrator
Project: _ iThaf\A-0 lic Works
ublic 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: Approved. 'Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
•
PLANNING & ZONING Reviewed b Date: et-j-149
TREE ADMIN. Second Review: Xpproved as revised. ❑Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES 4.--c-
PUBLIC SAFETY Reviewed 0 : Zni _ - ` _ Date: 'A_::_4_yp___. _
FIRE SERVICES Third Review: I 'Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
iL , ..
iftb.? �f CITY OF ATLANTIC BEACH
,., s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
(904) 247-5800
1;
,z Tie
PU IC WORKS PLAN REVIEW COMMENTS
Date: 2/5/2018
Permit#: DEMO18-0003 Site Address: 158 16th Street
Review
tus:
ENIE RE#: 171879 0000
Applicant: OSSI DCONTRACTINAPCrROVED Property Owner: OSSI CONTRACTING LLC
Email: OSS188@HOTMAIL.COM Email:
Phone: 9046103195 Phone:
THIS REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS
Revisions may not be submitted until ALL departments have completed their respective reviews.
Revisions submitted MUST respond to EACH department review.
Submittals that respond to only one or a few correction items will not be accepted.
Correction Comments:
• Provide construction site management plan including location of silt fence, dumpster, portable toilet.
Right-of-Way Permit is required if using right-of-way for construction parking
• Provide impervious surface calculations for entire lot (existing and post construction).
• Provide existing floor plan of house to receive credits.
Conditions of Approval to be Printed on Permit:
• Full erosion control measures must be installed and approved prior to beginning any earth
disturbing activities. Contact the Inspection Line (247-5814)to request an Erosion and Sediment
Control Inspection prior to start of construction.
• All runoff must remain on-site during construction.
• Roll off container company must be on City approved list (Advanced Disposal, Realco Recycling,
Shapell's, Inc., Republic Services, Donovan Dumpsters). Container cannot be placed on City
right-of-way.
• Full right-of-way restoration, including sod, is required.
• Provide construction site management plan, including location of silt fence, dumpster, portable
toilet. Right-of-Way Permit is required if using right-of-way for construction parking.
• All runoff must remain on-site. Cannot raise lot elevation.
• Strongly suggest thorough documentation of impervious areas be recorded.
Scott Williams, Public Works Director swilliams@coab.us (904) 247-5834
Page 1 of 2
Resubmittal Notes:
All revisions and changes shall clearly stand out from the rest of the drawing on the sheet as a revision by way of
completely encircling the change with "clouding".The revision shall also be identified as to the sequence of revision by
indicating a triangle with the revision sequence number within it and located adjacent to the cloud.The revision date
and revision sequence number shall also be indicated in a conspicuous location in the title block for each sheet on which
a revision for that sequence occurs. For projects still in the initial review stage and permit pending, all sheets with
revisions shall be inserted into each set of drawings.The original sheets must be clearly marked "VOID" but are to be left
within the set of drawings. Complete new sets of drawings will not be accepted.ADDITIONAL ITEMS MAY BE REQUIRED
DEPENDING UPON NEW INFORMATION AND CLARITY OF FINAL PLANS SUBMITTED FOR REVIEW.
Page 2 of 2
'T\ f � �` ' Lt_711P)
%'S�1.YriJ,
oliC j l CITY OF ATLANTIC BEACH
;ti_o'er FEB 1 3 2018 11 800 Seminole Road
r) 11-±1
; Atlantic Beach,Florida 32233
75 --Z:
till
FEB 18 2018 lj
REVISION REQUEST /CORRECTIONS TO PLAN REVIE OMMENTS
ham'J ./ g -J✓,
Date ? c7 / P- Revision to Issued Permit_ Corrections to Comments Permit#
DEMO l8- 000
Project Address 13 0 / 6 (4 5 f t ,,,:(
Contractor/Contact Name a 5 `>. (c n G C Jkit 06-T
i
Email MO
vs 7e ,F'I/i'lo �oPhone � J Y "�v �v '�/Q � � �
Description of Proposed Revision/Corrections: Permit Fee Due $
— PC b-, L., i,/tP etA c)1 0 , 171.4,
/11 44 4-A oneli#
Additional Increase in Building Value $ Additional S.F.
By signing below, I f 5 affirm the Revision is inclusive of the proposed changes.
(printed name)
"--)(434e7/ e`
Signature of C•e !' or/Agent(Contractor must sign if increase in valuation) Date
(Office Use Only)
Approved 7 Denied Not Applicable to Department
Revision/Plan Review Comments
Department Review Required:
Buil•mq /i_I l_ _ . _
Planning & Zoning F Reviewe s y
Tree Administrator
Public WR
ublic ilitie —,„2. C
Public Safety Dat
Fire Services
City of Atlantic Beach APPLICATION NUMBER
(4ui?I.
Building Department (To be assigned by the Building Department.)
800 Seminole Roadt- ,fin O v Atlantic Beach, Florida 32233-5445 DEA()Phone(904)247-5826 Fax(904)2 .�EI,E1
_an 9� E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us ': FEB 0 1 2018
APPLICATION REVIEW AND T ACKING FORM
Property Address: LS - ( Cp � De ent review required Yes No
p Y uildin
Applicant: 0 SS ( P-01\- -Ceile--C(/CC)N
Planning &Zoning
Tree Administrator
Project: TuII2Eiv-\...o Work
,fic
ic 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: proved. ['Denied. ['Not applicable
(Circle one.) Comments:
BUILDING
Y,,, -1/1/ ��ii11��
PLANNING &ZONING Reviewed by: ' `��� Date: (w--
TREE ADMIN. Second Review: ['Approved as revised. ❑Denied. ❑Not applicable
PUBL A'ORKS Comments:
d BLIC U�TII-LITIE
PUBLIC SAFET Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. ['Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
in\ Fri,L_-, (.(2.7 iLL:, Li 'd 11_, , r
;;S=„`!r!c, 1 ?_ — i, CITY OF ATLANTIC BEACH
�s
I,i
' '' ' FEB 1 3 2018 ! j' 800 Seminole Road
, • ...athy, 32233
____j , 1 FEB 16 2018 Li,
REVISION REQUEST /CORRECTIONS TO PLAN RE VIEVPt'6MMENTS
Q! J --/ Jam.
Date 2 �� l Revision to Issued Permit Corrections to Comments Permit#
DEMO l$-000 3
Project Address i 5-F 6 (4 5-4,_ ,,,-(
Contractor/Contact Name 0 5 <<.) n iablihi 4.- C Jfizit ('a- `
i
Phone 9 v T —(0 , J -2 /9 5 Email �� r) 5 5:‘ ,litrl y,�ot,!���f
Description of Proposed Revision/Corrections: Permit Fee Due $
— pc fr7 t, ,!a'p'p Q J c•10 f ---:. 4).„, r lam'
pie,Cf 4ft Me-i #
Additional Increase in Building/�`VValue $ Additional S.F.
" 0 rS affirm the Revision is inclusive of
the proposed changes.
signing below,IP p
(printed name)
i
Signature of C,i or/Agent(Contractor must sign if increase in valuation) Date
(Office Use Only)
Approved ✓ Denied Not Applicable to Department
Revision/Plan Review Comments Lo CA-f lArr/ c,( r7 CQ Abve_Q P)$
Department Review Required: /1
!nq
c
ff/C. 1,./. A._____.--
r-Buil
Planning & Zoning Reviewed By
Tree Administrator
Public MRS-
'
ork - ��
blic ilitie Z
Public Safety ate
Fire Services
Building Permit Application Updated 12/8/17
fll
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: ; lb k -` 5 Permit Number:
Legal Description C 16 t1/4 )v • RE# I r' i r c{ -
Valuation of Work(Replacement Cost)$ «•vc Heated/Cooled SF -3, ??t Non-Heated/Cooled e--?cl
• Class of Work(Circle one): New Addition Alteration Repair Move emo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial esiden
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes IV9 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:
D.y(.t.p 1,0 t)A
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: •.7c.c!_li c = Address: It '`� "t- S- '.
City Ale_7 ry C_ `'c-ex_L ,. State S- (- Zip S 1, Phone qui •-? .-t —L 3
E-Mail ?t-[ - Lc
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: (� �i p.� -' �� L 1 --( Qualifying Agent:
Address tit 2 3. A S t- �.,-k t<_ City&ALX,- C3.: -..v' State rL Zip -5 („
Office Phone 411i,c --Z 5- .-L - i -t Job Site/Contact Number (Lc:- — 2- > --6 lc;{
State Certification/Registration# E-Mail >:+ C-'> • ,"-L1-
Architect Name& Phone# C)9 L ; ri4 (-
Engineer's Name&Phone# /.L' . 5 ,•\ >4:7 i }
Workers Compensation 7 /J I I u 16 +� AQ P�^ ~' `�J '( . r' c 1 lC V 0 Z�13
P � �.r(?6 Y1[- — J
Exempt/Insurer/Lease Employees/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 FINANC NG, CONSULT WITH YOUR LENDER OR AN ATT NEY BEFORE
RECORDING YO R OT E OF COMMENCEMENT.
gnature of Owner or Agent) gnature of Contractor)
(including contractor) rn g
Signed and sworn to(or affirmed)before me this.'Ir day of Signed and sworn to(or affirmed)before me this `2j day of
jenm- --1 ZC ,by 34.1L 0 6L � �cTf'..t y , Z�i,'I(y by .3-E-c,k.G`SS' :3g. co co N
a
Q !n -a
(Signature of Notary) (Signature of tary) o E
E •o.o
o x o
cs w m
[ ]Personally Known OR . You;;'., DACODAH PARRISH [ I Personal, Known OR :�;'p';•.
[1oduced Identification =?°',� '''�;Commission#GG00994�v1'�roduce, Identification ?'.'4_!,°
Type of Identification: P L.-L, i , , 1 Type of Ide ification: R'lD L' 1 °=
•10:` �
Eq,;�PBonded royFainlnsurance800.385-7019
1 fl CITY OF ATLANTIC BEACH
r •r,,
s) 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
(904)247-5800
PERMIT NOTES
RESIDENTIAL DEMOLITION
February 7, 2018
158 16th Street OMPLtANCE
BP # DEMO18-0003 REVIEWED FDA LOD C BEACH
CITY SE POq 17S FOR ADDITIONAL
1. It is the responsibility of the contractor to: REDUIREMENTS AND CONDITIONS
a. Contact JEA to disconnect electric power. DATE; Z ° g
b. Locate and clearly mark all utilities. R�pEWED B :
c. Disconnect and cap off water, sewer, and gas lines. �.�, ,,�‘.7 -S +'°ra'�
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 be 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.
7. Adding fill dirt to the lot is prohibited, until approved by Public Works.
8. Prior permission from the Building Department is required Afore blocking any part of the
Right-Of-Way. ,#4'A
F�
1
OFFICE COPY
BOUNDARY SURVEY
Date Of Field Work-09/1812017 Drawn By-0 G. Order#:1000013653
A 158 16th STREET, ATLANTIC BEACH, FL 32233 1 ,!
I
16th STREET
_ -
ASPHALT ROADWAY o
40'RIGHT-OF-WAY o r
al
►� AERIAL PHOTOGRAPH
SCALE:1"=20' ' INOT.TO-SCALE)
FENCE _ _ --
0. r s,1.3'E 50.00— 90, �� 0.3'W OUND 112„
100_O�P) _ - o` 4� FENCE IRON PIPE
_ ----'v---- FOUND 112' r ah Z
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BLOCK al
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CORNER WITNESS
1.2'N ; N "' ..71.
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LOT 13
LOT14 .4' 63
LOT15 I BLOCK63o
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FOUND 1I2 f - " m LOT 10
Z LOT 9 BLOCK 63
IRON ROD z m BLOCK 63
-ALL ANGLES AND DISTANCES SHOWN HEREON ARE BOTH RECORD AND MEASURED UNLESS OTHERWISE NOTED
SHEET 1 OF 2(SKETCH OF SURVEY)-SEE SHEET 2 OF 2 FOR LEGAL DESCRIPTION AND OTHER SURVEY RELATED DATA.SURVEY IS NOT COMPLETE WITHOUT ALL SHEETS
Fl_is Xfil Ulf HE APPEARING ON THIS I•a : T
i. ' WAS AUTHORIZED HORIZEO BY
561.508.6272 C t''yOE O. MCNEAL
FAX:56516.51 058.6272
SURVEYING, LLC. 8.6309
LB 8111 PSM 2883 i"
ON 9/20/2017
5601 CORPORATE WAY, SUITE 103 NexgenSurveying.com .
WEST PALM BEACH, FL 33407 .. - d
OFFICE COPY
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