51 FORRESTAL CIR - DEMO r�S ' CITY OF ATLANTIC BEACH
ss
,' 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
�1;i>%' INSPECTION PHONE LINE 247-5814
DEMO - COMPLETE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: DEMO18-0005
Description: DEMO HOUSE - FIRE DAMAGE
Estimated Value: 6000
Issue Date: 3/7/2018
Expiration Date: 9/3/2018
PROPERTY ADDRESS:
Address: 51 FORRESTAL CIR
RE Number: 171738 0000
PROPERTY OWNER:
Name: CHAMBLISS ROBERT L
Address: 22 OAKS DR
JACKSONVILLE BEACH, FL 32250-2675
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: ALL AMERICAN DEBRIS
Address: P 0 BOX 24071
JACKSONVILLE, FL 32241
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.
ro..A��r,. City of Atlantic Beach APPLICATION NUMBER
r `j.S� Building Department (To be assigned by the Building Department.)
800 Seminole Road I ^/"'�0G, C
mss' �� C—_Mo t lJ CJ—�
-- - -�� Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
1119;" E-mail: building-dept@coab.us Date routed: Z-12-3 /I g
Z-12-3ty web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: -S I Department review required Yes- No
1B in ►/
Applicant: 'LL AIY\ Q.A-i'-' Dc2 - P nning &Zoning
Tree Administrator
Project: r-(R_E- E V\C
is ors >
u is ti i ies
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 PLICATION STATUS
fReviewing Department First Review: I" (Approved. ❑Denied. ['Not applicable
(Circle one.) Comments:
(UILDING_)
PLANNING & ZONING Reviewed by: //VI l Date: 3-/ "(9O18-
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
4
rT w Cityof Atlantic Beach '"
APPLICATION NUMBER
�� Building Department (To be assigned by the Building Department.)
800 Seminole Road FEB ? ? C-1...11A I Q-f')OW
",. Atlantic Beach, Florida 32233-5445 2O�g J
it/ Phone(904)247-5826 • Fax(904)2;5845 �j
z o;31�r/ Email: building-dept@coab.us �—_.� /Date routed: a /( p
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: -S i -1—.6 R R (A L Department review required Yes No
`B ' in
Applicant: ' t_ __. M F-2.(0.47.... ��'P�f' (S P nning &Zoning
} Tree Administrator
Project: I t a.�.. o, tic Works
u is ti i ie
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 by Date: 0,1i9fc4
TREE ADMIN. Second Review: Approved as revised. [1Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date: ./ /`O
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
yL�\. City of Atlantic Beach APPLICATION NUMBER
(� itAii1� Building Department (To be assigned by the Building Department.)
.y 800 Seminole Road FEB 2 3 2018 ,
-) Atlantic Beach, Florida 32233 5445 D CRMO L O.-010as
Phone(904)247-5826 • Fax(904)247-5845FEB
'� 0�3 �r E-mail: building-dept@coab.us
Date routed: a/z3 /1 P
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: -S i C3 IZ R (;*L,., Department review required Yes No
Applicant: -(,,L RA e t: j� oc_(),e_( S P nning &Zoning
Tree Administrator
Project: I isors
I?.E {Y C7
u is ti i ies
Public Safety _
Fire Services
Review fee $ 2-s Dept Signature % ---4-1-
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
PLANNING &ZONING Reviewed by: ' `1" ' w—_ Date:3/.1vf___
TREE ADMIN.
Second Review: I 'Approved as revised. ❑Denied. I 'Not applicable
PU:401ORKS) Com encs:
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ['Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
,, e i0 CITY OF ATLANTIC BEACH
�S f` Department of Public Works
J r? 1200 Sandpiper Lane
..,.____/:
Atlantic Beach, FL 32233
:'-`i...-4'Ji3!9r
(904) 247-5834
PUBLIC WORKS PLAN REVIEW COMMENTS
Date: 3/1/18 Applicant: All American Debris & Wrecking
Permit#: DEMO18-0005 (DENIED Demo) Address: 4118 Cransley Place
Site Address: 51 Forrestal Jacksonville, FL 32257
Atlantic Beach, FL 32233 Email: demobids@gmail.com
,
PUBLIC WORKS CORRECTION ITEMS `����/0
rV
(Submit the following to the Public Works Department in order for us to approve your application)
• Provide erosion and sediment control plans with installation details.
• All runoff must remain on-site. Cannot raise elevation.
• Provide a floor plan survey for pervious credits on rebuild.
PUBLIC WORKS CONDITIONS OF APPROVAL:
(The following comments will be printed on your permit as Conditions of Approval)
• Full erosion control measures must be installed an 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.
• All runoff must remain on-site. Cannot raise elevation.
• Strongly suggest thorough documentation of impervious areas be recorded.
• Slab and driveway to be fully removed.
Scott Williams, Director of Public Works swilliams(a)coab.us /904-247-5834
Page 1 of 2
THIS PLAN REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS
Any plan change must be submitted as a Revision to the Building Department at 800 Seminole Road.
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.
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
. OFFICE CrLiBuilding Permit Application Updated 12/8/17
City of Atlantic Beach
• ; , % 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 �nn O 8 ' �S
Job Address: S I FCS-CSPA•c, ein-et-C Sch.tw Permit Number: r v
Legal Description 30-541 le-2 '2 e A Tut.,TIC C3C.4CN ✓►ugGin,rl eAT)° / RE# 1711 38 -oOOO
Valuation of Work(Replacement Cost)$ (0000 Heated/Cooled SF 9 7-5- Non-Heated/Cooled /48
• Class of Work(Circle one): New Addition Alteration Repair Mov• Demo •ool 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 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:
Dtow -A re- otkmmed Ik s:c eAce.
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: IZ-o ISra-T L. CI4prN.4 S.S Address: 2-2- 0,4445 bM.t/C
City '5A4ouao.4✓.0 a t3&Aso State FL Zip 1- O- 247.5- Phone 9cAf-CSS 208
E-Mail go(3CA4Art 9L-tSS ATT.N
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: %U-4,4'vut 14.4^1 b & srt N+t{.tkn,,G;Gtr<.Qualifying Agent: J 0-4 C.avck
Address 'gill Cit ,-.StCi PL City 341'-Sv"11/14i.c State P-(-- Zip 32.20'7
Office Phone '1Oci-262--9Goo Job Site/Contact Number 94-262-54e0
State Certification/Registration# E-Mail bCnao (ii DS t Sm L .
Architect Name&Phone# N(A
Engineer's Name&Phone# ,JIA
Workers Compensation 4-t-0-€t-4 r.41 _
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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOT CE OF COMMENCEMENT.
(
airedAA
(Signature of Owner or Agent) (Signature of Contractor)
(including contractor) /� .
Sipped and swor t or affirm-•)befppre me this {� day of Sig?ed 0 nd sworn to( ,2 affirm-d)before me his .ay o LL
r. , ,by _,pct /Aim/7'055 1��i , �D by Ag %ft N1
00
s° rfigturs. (Signature o otary) _ III
Jr My Commission GG 164351 q U w
[ )Personally Known OR +aaExpires 11/30/2021 1 t p sonally Known OR
] 1
Produced Identificatio [ roduced Identificationt
ype of Identification: , Type of Identification: • �'
�,,;;, . ATLANTIC BEACH BUILDING DEPT.
..
rj r�"' DEMOLITION — PROPERTY OWNER
.} y,rte,
, 1 RELEASE FORM
:J v
Date: °Z4°Cl2,IS
To Whom It May Concern:
30-510 S8^2-S"2-cte
I /We the current property owners of: Lot /!ITLA,JTI C iR t4t N VILLA un I T 1
Block Lu T /0 t3e.-u 1
Legal Description of Property
AKA 5 1 Fo 2£S%4L- C 12ctE Saar H have contracted with to have
(Address of Property)
r,.,^
Yk I444C4-I01r1 D«SrLLS 4 Waea4/ J6,acto remove the 5t N1Ic FAA,icH har>h-f..
(Company Name) (Single Family,Duplex,Commercial,etc.)
Prior to the construction of : .
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.
X47c--tiitiw' s
Signature
odY"y,. Notary Public State of Florida
Signature a y ; John Musser
My Commission GG 164351
4.0r v Expires 11/30/2021
THIS SPACE FOR RECORDER'S USE ONLY
OWNER I i R
Signed: Date: l V ( V
Befe me this - day of ' ,oar in the ounty of Duval,State
Of Florida,has personally appeared ' '-r I c r,(t,5j
Notary Public at Large,State o Flori a,Countyof Duval.
My commission expires: I\ 3��--/47 Z
Personally Known: or
Produced Identification: 1:%L— D(,-
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