743 SAILFISH DR - PERMIT 17-DEMO-3199 City of Atlantic Beach '�:APPLICATION NUMBER
Building Department
p: e assigne y th e- Buildi fig Department)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 7q3 Sal Department review required Yes No
B 7M=rd(0�A;
Applicant: Y L Pc!��t es CL�_—s�rn P_1anriin�g &Zoning
Tree Administrator
Project:
Woff)
Qublic Ufi—liffa�
Public Safety
Fire Services
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: V�Approved. E]Denied.
(Circle one.) - Comments:
PLeNI'NG 8,MZONING
Reviewed by: Date:
TREE ADMIN.. Second Review: FlApproved as revised. FlDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. FlDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
en BuILDING PERMIT APPLICATION
W,
CITY OF ATLANTIC BEACH DATE
800 Seminole Road,Atlantic Beach FL 32233
Office: (904)247-5826 9 Fax: (904)247-5845
Job Address: W3 h� 041� Permit Number:
Legal Description 20
Valuation of Work(Replacement Cost) $ V, exileated/Cooled SF Non-Heated/Cooled
Class of Work(Circle'one): New Addition Alteration Repair Move 'e __ Pool Window/Door
in
in
__R ti
Use of existing/proposed structure(s) (Circle one): Commercial <,_:�es:ii:i!en t i��a
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes
No (L5D-/-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:
&wvk AyAc 6o'
L/
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: N�Ad &�ft x Z-Ze� A d d r,e s s: AIV-71 fiva; W
city ;ih %4- State Ft-Zip _1�2 2!�? Phone
E-Mail xi- CqL(
Owner or Agent (if�gent,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 NOTffE OF COMMENCEMENT.
Contractor Information:
lav ZeO4-4ualifying Agent: k/t�
Name of�Cxajny:
Address: 6itv State Zip 'PZ' 3��3:2
OfficePhone '70�170Y-3777 Job Site/Contact Number- '70Y-- 7_0'y--52- 77
State Certification/Registration# 1!�-6 3 RA L/ E-Mail-,V/- A0
Architect Name &Phone#
Engineer's Name &Phone#
Worker's Compensation Exempt / Insurer / Lease Employees / h jZ
stallations as indicated. I certify that no work or installation has commenced
d to ineet the standards of all,laws regulating construch.on i.n this jUrisdiction.
in six(6) months, or if construction or work is suspended or aban one or a
stand that separate permits must be securearfor Electri al Work um
itioners,etc.
Sianature of Contractor
Befor e �r /-
this V%v of Before me this
$tell
RIC,IA.j9U . RICHARD mo-rTp,A
MOTIOLA
Notary pj.-t�jc - Stale 01 Notarypti)tic.,sta
Notary Publi ublic: TP-0i Fiu,
399 # IF
MY COMM.Expires Sep 15,2019 M Y
COMM-Expires Sep 15,2019
Botidedtim
noes governing.this 0�pve of w r 7ill b7coRfi[Ted-w Tv ern :herein or not. '�qf 0 P r
I hereby certify that I have read and ------- e to be true and correcr_*
ordina The granting of ap�r
presume to give authorio)to WoKate oil ance.ltliepi-ovisionsofan.�othei-fedei-al, state, or local law regulating construction or the
peiforniance of construction.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
-5800
(904) 247
PERMIT NOTES
RESIDENTIAL DEMOLITION
February 27, 2017 R"1-Vd'E1,,',,JED FOR CODE CONIPUA,'�4CE
CITY OFATLANT-C BEACH
743 Sailfish Dr. SEE PERMITS FOR ZDITIONAL
BP 17-DEMO-3199 REQUIREMENTS AND CONDITIONS
REVIEWED BY:��, DATE:e>ZA2_
1. It is the responsibility of the contractor to:
a. Contact JEA to disconnect electric po�Wer.
b. Disconnect and cap off water, sewer, and gas lines.
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 f6r masonry structures and asbestos-containing materials.)
5. R, emoval of any trees requires a separate Tree Rem6val Permit, per COAB Code
Of Ordinances, Section 23-21.
16. Protection of trees and vegetation during construction is required, per COAB Code
Of Ordinances, Section 23-32.
7. Prior permission from the Building Department is required before blockitl6ypanrt of the
Right-Of-Way.
EE-CF,
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2 0 0 10 2
r0RIGINATION BENCHMARK I
GRAPHIC SCALE (In Feet)
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MONUMENT7 688"
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NOTES. 0
1. LEGAL DESCRIPTION PROVIDED BY CLIENT
z NO SEARCH OF THE PUBLIC RECORD FOR THE PURPOSE OF ABSTRACTING TITLE WAS PERFORMED BY THIS OFFICE Kenneth J.Osborne PSM#6415
3. NO SUBSURFA CE IMPRO VEMENTS WERE L 0 CA TED AS PAR T OF THIS 5 UR VEY THIS SURVEY IS NOT VALID WITHOUT
4. ALL ANGLES AND DISTANCES SHOWN HEREON ARE BO TH RECORD AND MEASURED UNLESS OTHERWISE NOTED THE SIGMA TURE AND THE ORIGINAL RA ISED SEAL
5. EL E VA TIONS SHO WN HEREON ARE BA SED ON N.G.V.D.1988 DA TUM,UNL ESS 0 THER WISE NO TED OFA FLORIDA LICENSED SURVEYORAND MAPPER
6. THE BEARINGS SHOWN HEREON ARE BASED ON THE CENTERLINE OF SAILFISH DRIVE EAST,ASSUMED TO BEAR N85-20'02-W
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
(904)247-5800
PERMIT NOTES
RESIDENTIAL DEMOLITION
February 27, 2017 FOR COI)e COAjPLj,4t4CiZ
C"ry OF-4TLAIVTIC
S=E PERA41TS FOR ADD EIEAC�j
743 Sailfish Dr. REQUIREA4Z- ITIOAIAL.
iNTS ANI)COIVI),TIOIVS
BP # 17-DEMO-3199
DAI*6.1
1. It is the responsibility of the contractor to:
a. Contact JEA to disconnect electric power.
b. Disconnect and cap off water, sewer, and gas lines.
p 'beginning
2. Silt fences must be in place and 4p roved by Public Works before
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 h6se 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 e -it per COAB Code
Of Ordinances, Section 23-21.
(- .o TA'
6. Protection of trees and vegetation during construct/* e,,i,` e�,`bet�tOAB Code
q
Of Ordinances, Section 23-32.
Z
7. Prior permission from the Building Department is _'�efdre' blocking any paft of the
Right-Of-Way.
17
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GRAPHIC SCALE (I Feet) ORIGINATIONBENCHMA
I I in I
:4zt S�
inch 20 ft. nTIONAL GEODETIC SURVEY
0,-A
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V, THEREOFAS RECORDED IN PLAT BOOK 30,PAGE 60 OF THE
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NOTES:
34
1. LEGAL DESCRIPTION PROVIDED BY CLIENT
I WAS PERFORMED BY THIS OFFICE Kenneth J.Osborne PSM#6415
2 NO SEARCH OF THE PUBLIC RECORD FOR THE PURPOSE OF ABSTRACTING T ILE
3. NO S UBSURFA CE IMPRO VEMENTs WERE L OCA TED AS PAR T OF THIS S UR VEY THIS SURVEY IS NOT VALID WITHOUT'
4. A L L ANGL ES AND DIS TANCES SHO WN HEREON ARE B 0 TH REC ORD A NO MEA SURED UNLESS 0 THER WISE No TED THESIGNATUREAND THE ORIGINAL RAISED SEAL V
5. ELEVATIONS SHOWN HEREONARE BA§ED'oN N.G.VD.1988 DATUM,UNLESS OTHERWISENOTED OFA FLORIDA LICENSED SURVEYOR AND MAPPER
6. THE BEARINGS SHOWN HEREONAREBASED ON THE CENTERLINE oFsAILFISH DRIVE EAST ASSUMED TO BEAR N85*20'02'W
Del JTM Color MFP S2825cdn
Fax Activity Report
Date/Time: 03/14/2017 11:58
Fax Number Page:l
Fax Header Name
*** Send ***
No. Job# Remote Station Start Time Dura. Pages Mode Contents Result
001 0911 92413745 03/08/2017 14 56 0'4 8 2/ 2 ECM Done
002 0914 918883135663 03/09/2017 07:26 1"6" 5/ 5 ECM Done
003 0922 918883135663 03/10/2017 07:18 0119. 1/ 1 ECM Done
004 0938 918883135663 03/13/2017 06:41 0-22- 1/ 1 ECM Done
005 0944 97228687 03/13/2017 10:14 1-11- 3/ 3 SG3 Done
006 0945 97228687 03/13/2017 10:17 0-33" l/ I SG3 Done
007 0951 98239995 03/13/2017 15:0 8 2-21" 6/ 6 SCM Done
Total 19
Received
No. Job# Remote Station Start Time Dura. Pages Mode Contents Result
001 0903 9043532700 03/07/2017 09:57 0'34" 1 G3 Receive Again
002 0904 8507474750 03/07/2017 10:56 013311 1 SG3 Done
003 0905 (888)683-8009 03/07/2017 12:28 012811 1 SG3 Done
004 0906 714-814-4579 03/07/2017 14:00 0,19., 1 SG3' Done
005 0907 904 2490703 03/07/2017 14:38 0-41- 1 ECM Done
006 - INTERFAX 03/07/2017 14:53 0-53" 0 ECM Receive Again
007 0909 INTERFAX 03/07/2017 14:59 1-13- 1 ECM Done
008 0910 ECM 03/08/2017 13:30 0-471- 2 ECM Done
009 0912 ECM 03/08/2017 15:23 0'58" 2 ECM Done
010 0913 7861984 03/08/2017 15:33 0"6" 1 ECM Done
Oil 0915 RCM 03/09/2017 07:38 0'47" 2 ECM Done
012 0916 8888415557 03/09/2017 09:47 0'36" 1 SG3 Done
013 0917 ECM 03/09/2017 10:56 011211 1 ECM Done
014 0918 Fax 03/09/2017 11:05 0-40" 1 SG3 Done
015 0919 9042727229 03/09/2017 11:39 013811 1 SG3 Done
016 0920 904-423-8577 03/09/2017 16:21 1-07" 2 SG3 Done
017 0921 ECM 03/09/2017 17:27 0.50., 2 BCM Done
ois - 03/10/2017 0 8:2 4 3-0911 0 G3 Receive Again
019 0924 3961136 03/10/2017 08:29 0-3111 1 SG3 Done
020 0925 3961136 03/10/2017 08:30 0-3311 1 ECM Done
021 0926 8888415557 03/10/2017 0 8:5 3 0-3211 1 SG3 Done
022 - 03/10/2017 10:05 1-33" 0 G3 Receive Again
023 03/10/2017 10:09 1-32'- 0 (33 Receive Again
024 03/10/2017 10:12 0.50., 0 G3 Receive Again
025 0930 9047213350 03/10/2017 11:21 0.3", 1 ECM Done
026 0931 ECM 03/10/2017 11:42 0-33- 1 9CM Done
027 0932 9047213350 03/10/2017 13:13 1-31" 1 ECM Done
028 - 03/10/2017 13:36 0-49- 0 G3 Receive Again
029 0934 8888415557 03/10/2017 13:52 0-511- 2 SG3 Done
Dell' is a trademark of Dell Inc.
Del JTM Color MFP S2825cdn
Fax Activity Report
Date/Time: 03/14/2017 11:58
Page:2(Last Page)
No. Job# Remote Station Start Time Dura. Pages Mode Contents Result
030 0935 INTERFAX 03/10/2017 13:59 1,16., 1 ECM Done
031 0936 3961136 03/10/2017 14:17 1-40" 1 RCM Done
032 0937 SG3 03/10/2017 14:32 0-35- 2 SG3 Done
033 0939 9048239995 03/13/2017 0 8 2 9 "'0., 3 SG3 Done
034 0940 SG3 03/13/2017 0 8 4 8 1-07" 3 SG3 Done
035 0941 9048239995 03/13/2017 09:38 1-28- 3 SG3 Done
036 - 03/13/2017 10:08 1132- 0 G3 Receive Again
037 03/13/2017 10:12 V32" 0 G3 Receive Again
038 03/13/2017 10:20 V321- 0 G3 Receive Again
039 03/13/2017 11:00 0"0., 0 G3 Receive Again
040 0948 9042498949 03/13/2017 11:03 0'36" 2 SG3 Done
041 - 03/13/2017 13:35 0'501- 0 G3 Receive Again
042 0950 ECM 03/13/2017 14:59 0-48" 2 ECM Done
043 0952 9044006440 03/14/2017 11:57 1.06., 1 ECM Print Queue
Total 47
Dell' is a trademark of Dell Inc.