1644 PARK TER W - DEMO (2) ,,� riii. �,,,`s, CITY OF ATLANTIC BEACH
1 - 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
!�;t > INSPECTION PHONE LINE 247-5814
DEMO - PARTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: DEMO18-0002
Description: DEMO SHED AND CARPORT
Estimated Value: 0
Issue Date: 1/30/2018
Expiration Date: 7/29/2018
PROPERTY ADDRESS:
Address: 1644 W PARK TER
RE Number: 172020 0164
PROPERTY OWNER:
Name: GRAMLING SCOTT R
Address: 1644 W PARK TER
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: MILLER CONSTRUCTION GROUP LLC
Address: 265 CAROLINA JASMINE LN
SAINT JOHNS, FL 32259
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.
SCANND
Date:3 1 _
s�i,=���i, City of Atlantic Beach APPLICATION NUMBER
i - lir.
,s• t :. ,;)t, Building Department (To be assigned by the Building Department.)
800 Seminole Road ( En1�o 1 U
,,,r ,; � Atlantic Beach, Florida 32233-5445 �' ��
Phone(904)247-5826 • Fax(904)247-5845
�! ;it!? E-mail: building-dept@coab.us Date routed: 1 I I c1 (1 F--,
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
De artment review required Yes No
Property Address: t�0�4 1� PRf�,� C-�I�Z � p
Building
Applicant: Mt LL i2_ 0 OIuS. Planning &Zoning
Tree Administrator
Project: -(V\C;-3 S (. F__D " 0A-R.P02_-7- - ublic Worksj
is i i ies
Public Safety
Fire Services
Review fee $ Dept Signature I
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 & ZONINGt�
Reviewed by: �1 Date:O t 2$It G>
TREE ADMIN. Second Review: ['Approved as revised. [Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Tlikvuitip'` Building Permit Application Updated 12/8/17
City of Atlantic Beach
W, 800 Seminole Road,Atlantic Beach,FL 32233
` Phone:(904)247-5826 Fax:(904)247-5845 I fl
Job Address: /$ 'Ai M 4 76€.(AIA3•��2 C $C#1 fL 3zg3Permit Number: ' €�O 1 C�
3
Legal Description St1.V4,fl.l( /A kmr6 6/tor f6 RE#
Valuation of Work(Replacement Cost)$ ( Heated/Cooled SF 2 sly Non-Heated/Cooled rto
• Class of Work(Circle one): New Addition Alteration Repair Mov: Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial 'esidentia
• If an existing structure,is a fire sprinkler system installed?(Circle one : Yes 10 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:
b60440 OA Acrsrieuq Soot-4 * AFrtIFle..O M/1.po27—
Florida Product Approval# /1A for multiple products use product approval form
Property Owner Information
Name: SC-07T jAIrilbO Address: /6f'pita T6/6C4CE W.
City AngNTic 8644 State Ft- Zip 3 22 3 3 Phone otloo ,36?
E-Mail sceirci @M.rli2ooa, SPA
Owner or Agenr(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Alta CD/r+ST/1KC1*d,4(Ave/ 6LGQualifying Agent: ,01 A.. 4L& 46C-
Address
,
Address 24.5�',¢�atjNi4 \7 tisA iOf GN City 5 f ,767,0.$ State `L- Zip�t ,S"j
Office Phone f9o9 2A4-0562- Job Site/Contact Number
State Certification/Registration# COC It51763 E-Mail r.Nilleda1 ►?c jRX.CoM
Architect Name&Phone# NQ
Engineer's Name&Phone# rA
Workers Compensation
Exempt nsurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to •• e 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 ATTORN BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
daft
(Signature of Owner or Ag-.1P (Signatu of Contractor)
(including contractor)
Signed and sworn to(or affirmed)b re me this I6lay of Signed and sworn to(or affirmed)before me this day of
',• REBECCA J.FITCHETT ( / _ t✓�
e4 Notary Public •State of-Florida `(Signature of Notary) nature of Notary)
•: :• Commission# FF 934464
' M Com E fires D c 30,2019 .O�ApYd�hy. MOHAMMED
, ,,yy f:-,: �,: KANDEL
'of o, ,,°r YeriB Comm, f°pikm tory Assn. [ ]Personally Known OR . Commission#GG 114942
r r
Produced Identification Pte,
xRire�s June 14,G2012141942 2021
Type of Identification: Type of Identification: J°,rpt' , "q dThnrTro,faininsurancesou-385.7019
--, t__ mac.,
, ,,:, 1J-\-1N-, ,
' k CITY OF ATLANTIC BEACH
'` _ � 800 SEMINOLE ROAD
j „r ATLANTIC BEACH, FL 32233
(904)247-5800
PERMIT NOTES
RESIDENTIAL DEMOLITION
January 28, 2018 RFV
1644 W Park ten. C ry FOR
BP # DEMO 18-0002 SE-E.P opq 1.CO .oC
�� REQU,aE,L,, s oii, a DD �PCIgNcF
1. It isahConta t JEA to disconnect electric to:
VI Cy
EwEo Ey T s ASO co.,ON ,
power. TioNs
b. Locate and clearly mark all utilities. `�. D,47-El'
c. Disconnect and cap off water, sewer, and gas lines. Z o o
C..
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 before blocking any part of the
Right-Of-Way. 0/4;4704,
cOA
Y 1