325 9TH St DEMO19-0013 DEMO PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH DEM019-0013
ISSUED: 5/13/2019
800 SEMINOLE ROAD EXPIRES: 11/9/2019
•r �' ATLANTIC BEACH. FL 32233
ALL WORK MUST CONFORM • • • • t • • • • •
CODE, NEC, IPIMC, 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 applicahle 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.
HOUSE FIRE DEMO ONLY / $0.00
3259TH ST DEMO PARTIAL REPAIR 2ND PERMIT
TYPE OF ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170036 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
PHILLIPS BUILDERS LLC 1250 SELVA MARINA CIR ATLANTIC BEACH FL 32233
OWNER: CITY: STATE: ZIP:
ADDRESS:
FRIEDERICHS BRIAN PHILIP 3786TH ST 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.
t PUBLIC UTILITIES UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL
OTCs:
void 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
DISCONNECT AND CAP INFORMATIONAL
Notes:
Disconnect and cap water and sewer lines.
Issued Date:5/13/2019 1 of 2
DEMO PERMIT PERMITNUMBER
CITY OF ATLANTIC BEACH DEM019-0013
r 800 SEMINOLE ROAD ISSUED:5/13/2019
rtv ATLANTIC BEACH. FL 32233 EXPIRES: 11/9/2019
3 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.
4 PUB UC UTILITI ES SEE ATTACHMENT INFORMATIONAL
Nates:
See Attachment-Tracking Comments
5 PUBLICWORKS EROSION CONTROL INSTALLATION INFORMATIONAL
Notes:
Full erosion control measures must be installed and approved priorto 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 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,All American Roll Off,WCA Waste Corporation). Container cannot be placed on City right-of-way.
7 PUBLICWORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
g PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
9 PUBLIC WORKS SLAB DRIVEWAY REMOVAL INFORMATIONAL
Notes:
Slab and driveway to be fully removed.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
DEMOLITION 455-0001322-1000 0 $100.00
PW REVIEW BUILDING MOD OR ROW 001-0000-3291004 0 $25'00
STATE DBPA SURCHARGE 455-0000-208-0700 0 $2'00
STATE DCA SURCHARGE 455-0000-208-0000 0
TOTAL:$129.00
Issued Date:5/13/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
n Building Department ^.` "y ,f -- (To be assigned by the Building Department.)
800 Seminole Road d... �C�619 —0013
_ Atlanbc Beach,Florida 322335445 -
Phone(904)247-5826 Fax(904)247-5845 j 2019
g E-mail: building-dept(o?coab.us Date muted:
—411 O L
Cityweb-site: mp:/M1 .coab.us
APPLICATION REVIEW AN TD RACKING FORM
Property Address: 3z 5 Cr'S De artment review re ulred Yes No
Applicant: PHI I,LIPS ,� DfL.i7G--QS Planning&Zoning
l- ^� Tree Administrator
Project: {- L R )F in Cp ublic Works
e
Public Safety
Fire Services
Review lRelptOther AgenInto
w or Permit RequiredDate
ofPermit
Florida Dept. mental ProteconFlodtla Dept. ortationSt.Johns Rivanagement District
Anny Corps orsDivision of HoRestaurantsDivision of Alverages and Tobacco V
Other
APPLICATION STATUS
Reviewing Department First Review: �3Approved. []Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by:f Date:
TREE ADMIN. Second Revlew: ❑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 05119/2017
City of Atlantic Beach APPLICATION NUMBER
.� Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
�
�� .�I� _Oo13
� Phone(904)247-5826 Fax(904)247-5845 ,/
I
E-mail: building-dept@JcoabAI Date routed: (]
— City web-site'. http://www.coabms
APPLICATION
QREVIEW AND TRACKING FORM
Property Address: 3Z5 i�T Department review required Ye No
Applicant: PNI (,uPS ��(>ILt7ES Plannin &Zoning
(� Tree Administrator
I—
Project: it RE (— )FGYI n ublic Works
u lc ti le
Public Safety
Fire Services
Review f
iew or ecei
Other Agency Review or Permit Required RevDate
of Permit VeRpt
rffled 8
Florida Dept.of Environmental Protection /c v
Florida Dept.of Transportation /� \
St.Johns River Water Management District Vrt_Y
Army Corps of Engineers
Division of Hotels and Restaurants ff
Division of Alcoholic Beverages and Tobacco V
Other:
AP--PLICATION STATUS
R //
Reviewing Department First Review: Approved. []Denied. ❑Not applicable
(Circle one.) Comments:
±IN
P NG Reviewed by: Date: YVIVZOV0
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: Dale:
Revised 05119/2017
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road ��019 —QQ 13
Atlantic Beach, Florida 32233-5445 ,l
Phone(904)2475826 Fax(904)247-5845 Dale routed: 4 I (]
E-mail: buildingdept@jcoab.us
jig
City web-site: http:/Mv .coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 37-5 911-- T cFireSewicesT
nt review re utred Yes No
Applicant: PNI LLI, PS SIR D(1.2)62S Zoning
(� �\ nistrator
I— I R E L )F in 0 ks
Project: le
ety
es
Review,or Receipt Date
Other Agency Review or Permit Required of Permit Verified B /
Florida Dept.of Environmental Protection ` (
Flonda Dept of Transportation l"
St.Johns River Water Management.District VR_Y
Army Corps of Engineers
Division of Hotels and Restaurants ff
Division of Alcoholic Beverages and Tobacco V
Other.
A!3131-19A<ON STATUS
Reviewing Department First Review: mrpproved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING - - �I _
PLANNING&ZONING Reviewed by: �'^--'�`�--�Uate:
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 051191201]
Building Permit Application OPdord 3019118
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: ,?;, - PIt--1 3L2,33 Permit Number: D M X19 -00/`13
Legal Description S (,q / b' 2g - Z't LCA 14 0LL' 12— RE# J'lCb3L/ -C=6
Valuation of Work(Replacement Cost)$Z710 W. Heated/Cooled SF Non-Heated/Coaled
• Classof Wark: ONew OAddition ❑Alteration ORepair []Move ODemo ❑Pool OWmdow/Door
• Use of existing/proposed structure(s): ❑Commercial []Residential
• If an existing structure,is a fire sprinkler system installed?: Oyes ONO
• Will trees be removed in association with Proposed. roject?[]Yes must submit separate Tree Removal Permit ❑No
Describe in detail the type of work to be performed: I-1WS� �-i r-C. �r pA,it
DP-m(-) PG R. N it
Florida Product Approval IX for multiple products use product approval form
PropertV Owner Information q T Lt $f
Name (F—Arbil t:t-�I.� Q: LAS Address 3 ZS
City A, (& - state t , zip "$ 22 3 3 Phone
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) —
Contractor Information �^t
Nameof�C ompany$�lW'1 PS tJS LI.G Qualifying Agent
Address C'{rv') TAI 7-7.wo 1eVc 3tz city N. State zip 3z z33
Office Phoncq Q4 74 L -I d Jo ite Contact Number
State Certification/Registration#CR C.)2S:!j34 E-Mail o:�. il-J,L�' 't-t•• fY.N2T _
Architect Name&Phone If
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or instal lation 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
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 ORE
REC D I YOUR NOTICE OF COMMENCEMENT
(Signature of Owner or Agent) �yy, ( ature of Contracto
Signed and sworn to(or affirmedTellefore me this Y' clayof_ Sind n sworn two
)be r me tis da�P` r S
l (� .bv P.V1 ,victL.O
Igate of FlaWg
yLk��
Ion 1*101ff1?JR021 Personally Known OR
[ ]Pee ly'Afi ��ggl95 1 ]Produced Identification �.t TONI GINUIESPEBGFA
1l Produced ode i Inv 1tC /� Q Ty
= M1IYCOMMISSIONi FF929951
Type of Identification: U LAI 1 T e of ldentitica[ion:
PUBLIC UTILITIES PLAN REVIEW COMMENTS
Date: 41/10111 C q Application g: _De 10 �q' 0013
Project Address: '52S
Check Box Check
APPLICATION TRACKING COMMENTS to Add Box to
Comma 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. 13 ❑
A sewer cleanout must be installed at the property line. Cleanout must he
RTI Sewer covered with an RT1 concrete box with metal lid. Cleanout to be set to grade ❑ ❑
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 ❑ ❑
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 At a minimum,will require a double check backflow preventer. 13 Cl
Requirement
Fire Une Fire Imes must be metered with a Sensus touch-read meter. Meters larger ❑ ❑
Meter than 2"must be Installed in a vault as noted In JEA specifications.
Utility Map bee attached Utility Map. ❑ ❑
Disconnect
i Cap Disconnect and cap water and sewer lines.
Inspection Must call the Inspection Une at 247-5814 to request an inspection of the ..
Prior disconnected and capped water and sewer lines prior to demolition.
❑ ❑
0 0
❑ ❑
NOTICE OF COMMENCEMENT SCANNED
Slate of{�\oks Ey4 Tax Folio No. D-W YI �� t 101
Countyof hWyAr�-- OFFICE COPY �EAMa1n%m Irlno
To Whom It May Concern: f STM'tc(eA-
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713
of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Desorption of property being improved: f'— 91 J 4; 2. t' —29 05 LOT 14 13 L Ic 1 1
Address of property being improved: T�* Fl.
General description of improvementse-Q " Q.
Owner: (L� P13 FQ.C1l i=.D-%l1U Address: �.Zl qT" �l •�A �t �ZZ�u 7i
Owner's interest in site of the improvement:
AOAA24
Fee Simple Titleholder(if other than owner): O o i 9 3 a
^I\. UztGF\- Q(,�t,�.y,Q l 0 m g 2
Name: m ,r
Contractor.
Address: 1'f2 ��Ng�tgqXJ Q C2 P-z 3zz33 $ 0„
Telephone No.QO4 Fax No: x m a
Surety(if any) n L ”
Address: Amount of Bond
g
Telephone No: Fax No: 0 3p
c d
Name and address of any person making a loan for the construction of the improvements y
0
Name: n
r
Address:
Phone No: Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may
be served:Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified): —
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signe �� Date:
% �� Before methis day of ti al i Caun of Duval,State
$fal9dflddd! Of Florida,has personally appeared i
�A�Canmlg9on E% �n2 Notary Public a[Large,State^f4 rida�ounty at'uval.
`� •^'! My commission expires:
fAfgg115 MNo.60266166 Personally Known: or
Produced ldentifcaT Y Lr 7L