1711 Beach Ave DEMO18-0039 demo permit DEMO PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH DEM018-0039
800 SEMINOLE ROAD ISSUED: 1/10/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 7/9/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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.
JOB ADDRESS: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
1711 BEACH AVE DEMO COMPLETE DEMO HOUSE $12500.00
TYPE OF REALIESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
NORTH ATLANTIC BCH
1696610000 UNIT 1
COMPANY: ADDRESS: CITY: STATE: ZIP:
Grider Construction 2057 VELA NORTE CIR Atlantic Beach FL 32233
OWNER: ADDRESS: CITY: STATE: ZIP:
PECORARO RUSSELL 1211 SALT MARSH LN FLEMING ISLAND FL 32003
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL
Notes:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(904-247-
5814)to request an Erosion and Sediment Control Inspection prior to start of construction.
2 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction. 71
Issued Date: 1/10/2019 1 of 2
DEMO PERMIT PERMIT NUMBER
DEM018-0039
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 1/10/2019
"it ATLANTIC BEACH. FL 32233 EXPIRES: 7/9/2019
3 PUBLICWORKS ROLL OFF CONTAINER INFORMATIONAL
Notes:
Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapells,Inc.,Republic Services,Donovan Dumpsters,
Phillips Containers,JDog/Dennis Junk Removal). Container cannot be placed on City right-of-way.
4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
MAT
5 PUBLIC WORKS RUNOFF INFOR IONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
6 PUBLIC WORKS DOCUMENT IMPERVIOUS AREA INFORMATIONAL
Notes:
Strongly suggest thorough documentation of impervious areas be recorded.
7 PUBLIC WORKS SLAB DRIVEWAY REMOVAL INFORMATIONAL
Notes:
Slab and driveway to be fully removed.
8 PUBLIC UTILITIES UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL
Notes:
Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is
needed,call 247-5878.
9 PUBLIC UTILITIES DISCONNECT AND CAP INFORMATIONAL
Notes:
Disconnect and cap water and sewer lines.
10 PUBLIC UTILITIES INSPECTION PRIOR TO DEMOLITION INFORMATIONAL
Notes:
Must call the Inspection Line at 247-5814 to request an inspection of the disconnected and capped water and sewer lines prior to demolition.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
DEMOLITION 455-0000-322-1000 0 $100.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
DO
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
00
TOTAL:$129.
Issued Date:1/10/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department ECEIV' ---(To be assigned by the Building Department.)
800 Seminole Road LOACt - -OU6(�
Atlantic Beach, Florida 32233-5445 1 OC-
Phone(904)247-5826 - Fax(904) 247-584 DEC 3 1 2018 F/ �
E-mail: building-dept@coab.us J1 Date routed. 'c>-) t
City web-site: http://www.coab.us lly
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1-7 L F_p,a L4 �Le Department review required Yes No
-Building -)
Applicant: C-\)N.-)a Planning &Zoning
Tree Administrator
Project: E -) Lf" r) .��ubric Works
,,,P6�icUtill`ifie ,
'::'P-�ui c a Wey
Fire Services
Review fee $ Dept Signature
Review or Receipt OND
Other Agency Review or Permit Required of Permit Verified By Date (Z�-C
Florida Dept. of Environmental Protection 0
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:
APPLIC, ION STATUS
Reviewing Department First Review: roved. []Denied. E]Not applicable
vpp
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed bv:
TREE ADMIN. Second Review: FlApproved as revis/d. E]Denied. [-]Not apoicabie
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05119/2017
City of Atlantic Beach APPLICATION NUMBER
"ts Building Department (To be assigned by the Building Department.)
800 Seminole Road
L)E,(Y\ r) CZ9
I Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 - Fax(904)247-5845
-1 E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
De ent review required Yes No
Property Address: EE-140(4 CAU& , 994-d-M,
Building_)
Applicant: Planning &Zoning
Tree Administrator
Project: 40 C_
.1-Public Utilitie�,3
P u 91 TcS-aTel_y�
Fire Services
Review fee $ Dept Signature
Review or Receipt
Other Agency Review or Permit Required of Permit Verified By Date
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
1 Reviewing Department First Review: WApproved. ODenied. E]Not applicable
(Circle one.) Comments: ;/-Q—
BUILDING PLa ri .1
PLANNING & ZONING Reviewed by: Date:
TREE ADMIN. Second Review: []Approved as revised. FIDenied. V DNot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ElApproved as revised. [:]Denied. [:]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road E
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247 5 Pt-c 3 2018 L
Date routed:
E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Department review required Yes No
Property Address: F_LL 0—(A �LC— . -Building
Applicant: C_� c- 2 c---,) F51anning &zoning
Tree Administrator
.;J�,u'bric;korks 7,
Project: (Ds
,,,FIU Zlic Ut�ilifies
a�ey
Fire Services
Review fee Dept Signature
Other Agency Review or Permit Required Review or Receipt Date 0 t3
of Permit Verified By ��>&y o F
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers LEA�S 0
Division of Hotels and Restaurants Iq
Division of Alcoholic Beverages and Tobacco
Other: [3
APPLICATION STATUS
Reviewing Department First Review: VApproved. [:]Denied. [:]Not applicable
(Circle one.) Comments:
BUILDING 4t
PLANNING &ZONING Reviewed by, Date:-/:;2
TREE ADMIN. Second Review: F]Approved as revised. F
]Denied. F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by.- Date:
FIRE SERVICES Third Review: DApproved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904)247-5845
Job Address: j In 8g" A W. PermitNumber:
Legal Description /52&LA44*�OOA Parcel#
Yloor Area of S qT. t—. Sq.Yt
Valuation of Work$ ZAA* Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move rom'o'litiopool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial esid ' V
If an existing structure,is a fire sprinCr system installed?(Circle one)4: ��iesRo
Florida Product Approval#
For multiple products use product approval torm
Describe in detail the type of work to be performed: �Wnoykp. cni,4,�7
Property Owner Information:
Name: tb�bSft_ll br(te4+, iC Amewiva Address: an so 4y F
city csjklft T-616AK State Zip,30126 3 Phone
E-Mail or Fax#(Optional
Contractor Information:
Company Name 6AYU44W V�C- Qual* g.Agent: (54% jW&0dr
Address: *209"b6kApp CA f city bai�, I State F7 Zip,3 2233
Office Phone 7 1 4L�' JobAe/Contact N ber Fax#
State Certification/Registration# C,
Architect Name&Phone# XXM_ U IPA Cc 90 a7f 7 0 7 2.
Engineer's Name&Phone jobAe '9011-112- 17 67
Fee Simple Title Holder Name and Address o-*'
Bonding Company Name and Address 0.10-
Mortgage Lender Name and Address 000"'
A I cat he e ade bana e do work and instal a i?n, i ndic or installation has commenced prior to the
a,, thisjurisdiction. This permit becomes null
0' i rs a geriod qfsij6)months at any time after
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T r C
anks At on,�kdoners,e
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.
lhere certify that I have read and exaT. dth' plication and know the same to be true and correct. All provisions oflaws and ordinances governing this
,ge I's _
1�work will be complied with whi r eci?ied herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions ofany otherfederal,state, or localsfaw regulating construction or the perfibmance ofconstruction.
Signature of Owner 01 jW jj 1� Signature of Contractor
Print Name per orato Print Name All'
..................................................................................................... ...............................................................
Sworn and subscribed before me Sworn and subsqribed before me
this IYADay of_Deto-tSct- 20 this 19AIDay of- Dt1,PR&(Ee 201'�
EAtvl�c 4g - 0A1,ktC
Notary Pu c CHERYL JEAN BARBER otary u ic
011 y'.."', CHERYL JEAN BARBER
Notary public-state of Florida
t,% Not%bllc-$totr,,qjj;FUk)ridal 0
Commission#GG 128679
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