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1830 MAYPORT RD DEMO19-0009 DEMO PERM DEMO PERMIT PERMIT NUMBER DEM019-0009 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 3/22/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 9/18/2019 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: 1830 MAYPORT RD DEMO COMPLETE demo east/west section of $5000.00 building TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: --GROUP: 1720750200 SECTION LAND COMPANY: ADDRESS: CITY: STATE: ZIP: MASTER BUILDING 484 Whiting Lane Atlantic Beach FL 32233 CONTRACTORS, LLC OWNER: ADDRESS: CITY: STATE: ZIP: OSSI KLOTZ LLC PO BOX 330833 ATLANTIC BEACH FL 32233 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 UTILITIES UNDERGROUND WATER SEWER UTILITIES _T INFORMATIONAL Notes: 0 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. 2 PUBLIC UTILITIES METER BOX SEWER CLEAN OUT INFORMATIONAL Notes: Ensure all meter boxes,sewer cleanouts and valve covers are set to grade and visible. Issued Date:3/22/2019 1 of 3 DEMO PERMIT PERMIT NUMBER SS CITY OF ATLANTIC BEACH DEM019-0009 ISSUED: 3/22/2019 800 SEMINOLE ROAD 9il ATLANTIC BEACH. FIL 32233 EXPIRES: 9/18/2019 3 PUBLIC UTILITIES DISCONNECT AND CAP INFORMATIONAL Notes: Disconnect and cap water and sewer lines. 4 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. 5 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. 6 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. 7 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. 8 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. 9 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 10 PUBLIC WORKS DOCUMENT IMPERVIOUS AREA INFORMATIONAL Notes: Strongly suggest thorough documentation of impervious areas be recorded. 11 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL Notes: Work area must be fenced off and protected. 12 F_ PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL Notes: Mayport Road sidewalk must be protected. 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 Issued Date: 3/22/2019 2 of 3 DEMO PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH DEM019-0009 ISSUED: 3/22/2019 800 SEMINOLE ROAD EXPIRES: 9/18/2019 ATLANTIC BEACH, FL 32233 STATE DCA SURCHARGE 455-0000-208-0600 52.00 TOTAL: $129.00� Issued Date:3/22/2019 3 of 3 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road 0 0 0 ci� Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 uted- E-mail: building-dept@coab.us Date ro City web-site: http://vvww.coab.us 'I APPLICATION REVIEW AND TRACKING FORM Property Address: :�C' _QqpArtwent review required Y No Building ) -7 Applicant: Ct ci _rGnining &Zoning Tree Administrator Project: I Public Utilities Public Safety Fire Services Review fee Dept Signature Other Agency Review or Permit Required Review or Receipt Date Florida Dept. of Environmental Protection of Permit Verified By 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 i Reviewing Department First Review: dApproved. ElDenied. [—]Not applicable (Circle one.) Comments: (B:U:l:LD;D PLANNING &ZONING Reviewed by: Date:?// TREE ADMIN. Second Review: [—]Approved as revised. ]Denied. E]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 05/1912017 City of Atlantic Beach ECEIIJE" APPLICATION NUMBER (To be assigned by the Building Department.) Building Department 800 Seminole Road -5445 t MAR 12 2019 rpAt-,/A 0 t C1 C)C)o pt Atlantic Beach, Florida 32233 Phone(904)247-5826- Fax(904)247-5845 LDate routed: E-mail: building-dept@coab.us City web-sitei http://\vww.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Buildin ent review required Yes No Applicant: pal� a6l Plann ng &Zoning Tree Administrator Project: iltS-IlF twLk P Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Date Florida Dept. of Environmental Protection of Permit Verified By 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: VApproved. ElDenied. nNot applicable (Circle one.) Comments: BUILDING r Revie PLANNING &ZONING wed b ///z" Date: c TREE ADMIN. Second Review: FlApproved as revised. ElDenied. FJNot applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: FlApproved as revised. E]Denied. UNot applicable Comments: Reviewed by: Date: Revised 05119/2017 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Departme I nt.) 800 Seminole Road D 0 01� Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 Date routed: E-mail: building-dept@coab.us Cityweb-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Devaiiaent review required Yes No Property Address: Buildi L nt revie L4 C1 w Plann ng &Zoning Applicant: c I ree Administrator Project: (y) Public Utilities 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: APPLI ION STATUS Reviewing Department First Review: pproved. E]Denied. E]Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed b Date: !w TREE ADMIN. vi Second Review: RApproved as revi ed. RDenied. ONot applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: FlApproved as revised. DDenied. UNot applicable Comments: Reviewed by: Date: Revised 0511912017 FFICE COPY Building Permit Applicationo Updated 10/9/18 City of Atlantic Beach Building Department "ALL INFORMATION 800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY Phone: (904) 247-5826 Fax: (904) 247-5845 Email: Building-Dept@coab.us IS REQUIRED. Job Address: IJ30 APyPQe_7- 12e,4Z Permit Number: Legal Description 4- RE# / 7_hl 2S- 0.200 Valuation of Work(Replacement Cost)$ cqoo-�O- Heated/Cooled SF pjff)VAE aw • ClassofWork: ONew DAddition DAlteration DRepair DMove ODemo OPool DWindow/Door • Use of existing/proposed structure(s): 0commercial [:]Residential M A R 2019 • If an existing structure,is a fire sprinkler system installed?: E]Yes [j3No • Will tree(s)be removed in association with r)ror)osed oro6ectAles(must submit seDarate Tree Removal Permit) �&o n detail the type of work to be performed: BUIlding Department Cilly 0 a, Beach, FL Florida Product Approval# h17A_ for multiple products use product approval form Property Owner Information Name 055i klal-Z I-Le- Address city #r44,o .e &-4 r-.1� -State j47 zip -3-2.2 :33 'Phone Qa V -�?ly 1- 53.3 q E-Mail __7X107'7_ R "116 Owner or Agent(if Agent, Power of Attorney or Agency Letter Required) n/a Contractor Information Name of Company 117,4S7'6_1t 6141'40i,(A -6V7444r041 QualifyingAgent J,64A.) & JZIAIL)-0041 Address �W kJ,6i-r-,4(4 LdAefge City 4rL�4,y;"*L -State_j6=__Zip Office Phone 90 VA 3- 3?;f f S_ Job Site Contact Number '?,P I/ 'Vib-3 7.9 V S- State Certification/Registration#I if A e /.2-5'-4-0 q-0 E-Mail _f64AJCrQ6VSQV Architect Name&Phone# A)Iq Engineer's Name&Phone# VZ?� Workers Compensation Insurer/ ir V,4rl�" _T4kUAqA)eZ- d4D OR Exempt Ei Expiration Date 1/0/1.-2-019 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 It- 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 req4 ments of th �F in- permit,there may be additional restrictions applicable to this property that may be found in the public records of 06county,and'�� there may be additional permits required from other governmental entities such as water management districts,st agende4 or federal agencies. M -1- -4 6 �;, -0 CL OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in complialyc*6 applicable laws regulating construction and zoning. 0 ca Z U no WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF Y _J LL 1F, TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR A RN EFOR I.— (n < t= Z RECORDING YOUR NOTtCE OF COMMENCEMENT. U. 2 W 1�� 777 7UM2 J IUVJ __ _ M �&�ture of owvnVr—orAgen6-J (Signature of Contractor) LU P 't UJ C3 W Signed and sworn to(or affirmed)before th 4W Lu Signed and sworn to(or affirmed)before me this Z�nay of me da9zf w > Zelh&A .2-Ole by A t1e7_Z- _)01-9 by J�_--4 A) i4ld� - — ignat%^9f.%RqWk _251 - (Signature of Notary) NOTARY PUBLIC LISA A.BINDER -STATE OF FLORIDA NOTARY PUBLIC ,to(Personally Known OR Comm#FF189043 1>6ersonally Known OR STATE OF FLORIDA Produced Identification Expires 1/12/2019 Produced Identification Comm#FF189043 1. . ..1. .. �_-S TVS117;_EXDire% I/ig/gnio .S __i� CITY OF ATLANTIC BEACH OFFICE COP 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. I 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: 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 PUBLIC UTILITIES PLAN REVIEW COMMENTS Date: 311.3111 Application#: 'Defn 0 11— 6 0 Project Address: Check Box Check APPLICATION TRACKING COMMENTS to Add Box to Comrner�/ 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. 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 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 0 [3 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 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 Requirement 1 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 [3 Meter than 2" must be installed in a vault as noted in JEA specifications. Utility Map See attached Utility Map. Disconnect &Cap Disconnec�tancl�chd Inspection M 1, b6nspection Line at 247-5814 to request an inspection of th Prior clZc�tted and capped water and sewer lines prior to demolition. 0 0 0 13 0 El