320 10th St. DEMO19-0007 Demo existing home rs �'fin` DEMO PERMIT PERMIT NUMBER
vg CITY OF ATLANTIC BEACH DEMO19-0007
Jr ISSUED:SEMINOLE ROAD 3/19/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 9/15/2019
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: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
320 10TH ST DEMO COMPLETE demo existing home $17900.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170032 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
HERITAGE HOMES OF JAX, 2451 3RD ST JACKSONVILLE FL 32250
INC BEACH
OWNER: ADDRESS: CITY: I STATE: ZIP:
BRECHBILL ALAN L 479 ENGLISH IVY CT HUMMELSTOWN PA 17036
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.
1 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.
Issued Date: 3/19/2019 1 of 2
DEMO PERMIT PERMIT NUMBER
, DEMO19-0007
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 3/19/2019
P-011 ATLANTIC BEACH. FL 32233 EXPIRES: 9/15/2019
3 PUBLIC WORKS 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,All American Roll Off,WCA Waste Corporation). 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.
5 PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
6 PUBLIC WORKS SLAB DRIVEWAY REMOVAL INFORMATIONAL
Notes:
Slab and driveway to be fully removed.
7 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL
Notes:
Any damage to sidewalk must be replaced by Contractor.
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 INSPECTION OF THE DISCONNECTED AND CAPPED WATER AND SEWER LINES PRIOR TO
DEMOLITION.
FEES
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
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$129.00
Issued Date:3/19/2019 2 of 2
01.:Ly;. City of Atlantic Beach APPLICATION NUMBER
9 Building Department (To be assigned by the Building Department.)
• 800 Seminole Road i"\� 01 G�.� i1
;j.. r� Atlantic Beach, Florida 32233-5445 }�1�!M t
Phone(904)247-5826 Fax(904)247-5845
st �' E-mail: building-dept@coab.us Date routed: 3 I IP I i
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 (VD lb � �� 1-_ ___Iment review required Ye No
Buildi
Applicant: *IAQ(1 ( (\AJ (�� ,�G� K Planning &Zoning
Tree Administrator
Project: L ori U _ tt.,5 � `Vei1' Public Works
ublic Utilitie
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:
UILDING
PLANNING &ZONING
Reviewed by: _ Date:
TREE ADMIN. Second Review: ['Approved as revised. Denied.
❑ pp ❑ ❑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
Building Permit Application
f
_ Lipooted10/9/12
City of Atlantic Beach Building Department• OFFICE COPY
**ALL INFORNIATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-DeptPcoab.us IS REQUIRED,
Job Address, 320 10th ST Atlantic Beach FL 32233 Permit Number. 0 e-M o 1 c1
- C(7
Legal Description 5-69 16-2S-29E A rLANric BEACH W 20FT LOT 7,LOT 9 BL K 12 RE e 170032-0000
Valuation of Work{Replacement Cost)S 17900 Heated/Cooled SF Non- Heated/Cooled
• Class of work' '.1New DAcidition DAlteration DRepair EMove X1Demo OPool OWindow/Door
* Use of existing/proposed structure(s): E.:Komar'e r c 1 al lResidential
MAR - 6 2ni0.
• If an existing structure,is a fire sprinkler system installed 0Yes ONo
• Will treei,si be removed in association with proposed protect? IXIYes(must 50tirrIlt separate Tree Removal P•rmi - No Q
Describe in detail the type of work to be performed: W
Remove existing single family to replace with new home 0
Z (r)
-1
1 da Product Approval 0 for multiple products use product agiurValogli (\r)
Property Owner Information LI.1 F.., 6 tu
0 ca a A '-
Name Alan L Brechbill Address 479 English Ivy Cl C-) 0 o 5
city Hummelstown State PA zip 17036 phone .1267)566-0364 ._... 4
FiArrafl abrechbillpermstatehealth_osu edu
0 ier 0 <
Owner or Agent III Agent, Power oAtrior ece, or Agency Letter Required) 0 LL
...I VI
i•-• CI) !-
Contractor Information IX < I= z
IJJ
Name o Company Heritaie Homes of lax Inc Qualifying Agent L.Scott U0 lm „ „„____Ll.. •r-- ‘--
___,„....._
Addre%s 2451 3rd ST S „City Jacksonville Beach St7ite FL 71 i.3 32.254 U Ul 41 5:
tri-e , ct. 03
Office Phone (904)8436-0990 Job Site Contact Number (904'63S-2087 U.I 0
:itate Cenification/Regrstiation e CGC047108 E-Maii jason@hefitagehornesjax..com —_ WØ LU
tij V in 111
Architect Name&Phone 0 Kevin Muliitan {904)434-1493
CC W
, 5
Fngmeer's Name&Phone 0 „ tou_polgo,(904)242-0908 Li 5
_ w
Workers Compensation insure, ,Greene Hazel Insurance Group OR ExemptC.t. Expiration Date 7/1/2019Cg CC
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 regulating
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
ipplicable 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 NOTICE OF OIVIIVIENCEMENT.
iSignature of Owner or ri•enti (Signature of Contractor)
;-;
,:.i k 1.4,'''
Si-ned and sworn to(or affirmed)before - this /A day of Vned and sworn to{or affirrnij before me this .ay of
, by P. ".$...o... ."-tvii.r..-- fibtlek. , ,2 0 I 9 , b -7,e t e., .5- V 0 a
. i ... j4004 j . ; -/IPRP'
....
• '..5 1 3 74•.....r. - Arnow —
BRANDON Mfit.A. (Si nature of Notary)
Official Seal
.••,............. S.ROMBERG
Notary Public-State of Illinois TEMPLE
ill feroTi'arPriEc2.4;;,O(' 15, 2022 v( (4 1..1 COMMISSIOn SI GG299899
( Personally kn;, 1-‘t,!''1,„,,sw 10,2023
4 pro.uceil .-nti'cation A ir • . Expires February
I I Produced icy,r: i'''"411N`.1.1.s.‘ Bonded Thru Troy Fain Ineursnce 80045-7019
Type of Identification: 0 i e Ad*-5' 1,, •-e-e-clvre Type of blew
CITY OF ATLANTIC BEACH
OFFICE C Q 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
(904) 247-5800
BULLETIN 4-18
To: All Permit Applicants.
From: Dan Arlington, CBO
City Building Official
Date: October 30, 2018
Re: DEMOLITION OF STRUCTURES.
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.
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. Removal of any trees requires a separate Tree Removal Permit, per COAB Code
Of Ordinances, Section 23-21.
5. Protection of trees and vegetation during construction is required, per COAB Code
Of Ordinances, Section 23-32.
6. Prior permission from the Building Department is required before blocking any part of
the right-of-way or side walk.
Dust and wind-borne debris generated from the demolition of a structure is considered
unsafe and a hazard to the public health, safety, and welfare of residents in the
surrounding areas.
When demolishing a structure, the following steps are required to ensure that the
minimum dust and debris leaves the property:
1
OFFICE COPY
7. At least two hoses, with nozzles, capable of reaching to all areas of the property must be
on site with an adequate water supply.
8. The structure must be sprayed with water for one hour before demolition begins.
9. The hoses must be used continuously during demolition, wetting down the structure, the
debris pile, and truck beds when being filled.
ASBESTOS.
10. All roofing and siding made from asbestos containing materials (ACM) are considered
friable and must be removed from the structure, following NESHAP Guidelines, before
demolition begins. This includes all commercial and one and two family residential
dwellings.
Please call for a Pre-Demolition Inspection, before demolition begins, and a Final
Inspection, when demolition is complete.
11/01/18
2
,o..-=‘1.u, City of Atlantic Beach APPLICATION NUMBER
(61 i� Building Department (To be assigned by the Building Department.)
= If 800 Seminole Road = ' ' /til DI ‘I- UL�
f' Atlantic Beach, Florida 32233-5445 a 'f-'�-- I
\-) r
~ Phone(904)247-5826 Fax(904)24 -580AR 2019 ',
�;i 9.1" E-mail: building-dept@coab.us Date routed: 3 1 tQ
City web-site: http://www.coab.us
APPLICATION REVIEW AND--TRACKING FORM
Property Address: a T 1 -- ST . Impartment review required Yes No
BuildiEgj
Applicant: IA e.f4a5t-kINAIA OF ja x Planning &Zoning
Tree Administrator
Project: aL(YI.0 tit.) AL \1�u( Pub�ci or s,
Fsublic Utilitie
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: pproved. Denied. 1 INot applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed c : i/ _ z....... Date: ' (1,
i
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. I 1Denied. 1 1Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
rt�L�;y' City of Atlantic Beach APPLICATION NUMBER
4 * i
PUBLIC UTILITIES PLAN REVIEW COMMENTS
•
Date: jc- t iI -0Application#: -Dern Cal
I `
Project Address: 3,2_0
Check Box Check
APPLICATION TRACKING COMMENTS to Add Box to
Comment Print
Underground Avoid damage to underground water and sewer utilities. Verify vertical and
Water Sewer horizontal location of utilities. Hand dig if necessary. If field coordination is
Utilities needed, call 247-5878.
Meter Boxes Ensure all meter boxes, sewer cleanouts and valve covers are set to grade
Sewer Cleanout and visible. ❑ 0
A sewer cleanout must be installed at the property line. Cleanout must be
RT1 Sewer covered with an RT1 concrete box with metal lid. Cleanout to be set to grade 0 0
Cleanout and visible.
A reduced pressure zone backflow preventer must be installed if irrigation will
RPZ be provided or if there is a private well on the property. Backflow preventer ❑ ❑
Backflow must be tested by a certified tester and a copy of the results sent to Public
Utilities.
Plans note the building will be unsprinkled. If plans change, any fire line
Sensus installed must be metered with a Sensus touch-read meter in a properly sized
Touch-Read vault and an appropriate backflow preventer installed. Backflow preventer 0 0
Meter must be tested by a certified tester and a copy of the results sent to Public
Utilities.
Fire Sprinkler If fire sprinkler system is provided,call 247-5878 for backflow requirements.
Backflow 0 0
Requirement At a minimum,will require a double check backflow preventer.
Fire Line Fire lines must be metered with a Sensus touch-read meter. Meters larger
0 ❑
Meter than 2" must be installed in a vault as noted in JEA specifications.
Utility Map See attached Utility Map. 0 0
&Ca Disconnect � ;, .nd cap water and sewer lines.
p
Inspe• • Must call the Inspection Line at 247-5814 to request an inspection of the
Prior f disconnected and capped water and sewer lines prior to demolition.
❑ ❑
❑ 0
O I 0
, fit. _
—.Serving all or Florida— �_
- •6. s
PROPERTY ADDRESS: 320 TENTH STREET ATLANTIC BEACH,Florida 32233 SURVEY NUMBER: FL1201.0239
FIELD WORK DATE: 1/6/2012 REVISION DATE(S):(rev.t 1/9/2012)
FL 1201.0239
BOUNDARY SURVEY r LI� PIR
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I hereby certify that this Sketch of Survey of fhe hereon described f31_1c. 12 Fit K, I?
property has been made underm .'•• i.n,and to the best of my
knowledge and belief,it is a..A:•:.'. .resentation of survey
that meets the minimum •. ."s arida"ff/Y ;t.h by the Florida Board
OfPrafessionalLand •yorsas4'gg ibedA el..ter 51-17 of the
l'e. 30 1111111r MM 0 15 30 '��
Florida Administrative
STATEOlmlon GRAPHIC SCALE (In Feet)
STATE OF uw (,
Timothy
state• rklaProle••bRn�alsurveytx: .• apper 1 inch = 30' ft.
psi t �Noo.A..• y ,'���
(4^C SURVCYO¢
Use of Thls Survey for Purposes other than Intended,Without Written Verification,will be at the User's Sole Risk and Without Liability to the Surveyor. I :I
Nothing hereon shall be Construed to Give ANY Rights or Benefits to Anyone Other than those Certified.
FLOOD INFORMATION: POINTS OF INTEREST
By performing a search with the local governing municipality or www. NONE VISIBLE
fema.gov,the property appears to be located in zone X.This Property was
found in THE CITY OF ATLANTIC BEACH,community number 120075,
dated 04/17/89. — -- -- -- — — -----—
TANSY MOON REALTOR®
i ...........1 .__________ . ,
CLIENT NUMBER: DATE: 1/9/2012 '�' '
-
9111-517-A111 * Prudential k —