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365 10th St DEMO19-0025 House DEMO PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH DEM019-0025 800 SEMINOLE ROAD ISSUED: 9/25/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 3/23/2020 MUST CALL INSPECTION • i • 1 i PM FOR • • ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF i ' 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: 365 10TH ST DEMO COMPLETE DEMO HOUSE $2450.00 TYPE OF ZONING: : • • • • GROUP: 170085 0000 ATLANTIC BEACH COMPANY: ADDRESS: CITY: STATE: ZIP: JAX DIRTWORKS INC 310 Mealy Dr Atlantic Beach FL 32233 OWNER: A• • ' ' ' FAVERGRAY HOMES LLC 415 PABLO AVE JACKSONVILLE FL 32250 BEACH 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: 9/25/2019 1 of 2 fSL:L'j�� DEMO PERMIT PERMIT NUMBER DEM019-0025 CITY OF ATLANTIC BEACH ISSUED: 9/25/2019 800 SEMINOLE ROAD P % ATLANTIC BEACH. FL 32233 EXPIRES: 3/23/2020 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. No fill dirt can be added. 6 PUBLIC WORKS SLAB DRIVEWAY REMOVAL INFORMATIONAL Notes: Slab and driveway to be fully removed. 7 PUBLIC WORKS GRASS INFORMATIONAL Notes: Full site to be grassed. 8 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL Notes: Any damage done to infrastructure must be repaired by Contractor. 9 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. 10 PUBLIC UTILITIES DISCONNECT AND CAP INFORMATIONAL Notes: Disconnect and cap water and sewer lines. 11 PUBLIC UTILITIES INSPECTION PRIOR TO DEMOLITION INFORMATIONAL Notes: 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:9/25/2019 2 of 2 I� � = City of Atlantic Beach I -� -_ APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road SEP 12 209 `} Atlantic Beach, Florida 32233-544 Phone(904)247-5826 - Fax(904- ;5845 Q E-mail: building-dept@coab.us --- Date routed: 1 Z City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: J lOs I C) J\T Department review required Yes No -Building_,) Applicant: 1(Z`rl�l�t���� -Manning &Zoning I Tree Administrator H Project: ��0 o os Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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 o Other: �J APPLICATION STATUS Reviewing Department First Review: V pproved. []Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed b ` T ate: C 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 05/1912017 Building Permit Application Updated 10/9/18 `J 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. 3 � ;- 1040 s� �Arno l Ci --db z,5 Job Address: Permit Number: Legal Description 5417 /(,�S'o � f/ank QGlh Z04 30 a,4A;, RE /700,S:4—'Ooco Valuation of Work(Replacement Cost) $ `I �� Heated/Cooled SF x.73�/ Non-Heated/Cooled 9��/ • Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move KDemo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial fResidential • If an existing structure,is a fire sprinkler system installed?: Dyes gTNo • Will trees be removed in association with proposed ro'ect? ❑Yes must submit separate Tree Removal Permit o Describe in detail the type of work to be performed: & C 1 d� S� sti r AomG Florida Product Approval# for multiple products use product approval form Property Owner Information Name Address y1S— Ra blo AW11— 5u, k 2w City State Zip 3,�ZC7> Phone QG(�SC6�—a_� E-Mail ./Y1 Owner or Agent(If gent, Power of Attorney or Agency Letter Required) Contractor Information I Name of Company �r�,r- �,t^/�f Qualifying Agent ,egnlaCr— lY+'rin Address City �}" ,� j'L State /�4_ Zipy�3 Office Phone — 3/ G Job Site Contact Number G 6/ Q h doO State Certification/Registration# 3,79 E-Mail �ctt% ir�Lu,�Cl_ COr Architect Name& Phone# Engineer's Name&Phone# Workers Compensation Insurer n k OR F:<empt ❑ Expiration Date / 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 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 ATTOR EFORE RECORDI NOTICE OF COMMENCEMENT. (Si ature of Owner or Agent) at of Contractor) Signed and sworn to(or affirmed) before me this day of g- ed aJ�d sworn to(or of-rmed)before me this/ I day of 7bh' �1 q ,by µhS � t�n (' by ignatLVe of Notary) tiY oo•. SYDNEY KILAH CLEMENT • U` Notary Public-State of Florida DAWN LEWRE Commission#GG 198331 personal) Known OR y MY C MMISSION M GG3100 [�] Personally Known OR ''orM MY Comm.Expires Mar 20,2022 ] y I23 [ ]Produced Identification Bonded through National Notary Assn. ] Produced Identification EXPIRES:Apri Type of Identification: Type of Identification: ,�,•` Bonded thru CAN Surd LOT !! FSO LOT a1 FNO LOT aT t 50.00 90009'00— 89° 51'00" )TfY• ALL CNA,N UMR FfNCf AMNLfa QITAOLISN!•D mrsir FSfLD. i O 0' 10' Zd JO y •R✓NIC 4611 suu 1"• m' LOT J2 LOT 70 LOT 21 I� y1 N � ^ i n F L .fTORr M000 nui 5. O A i ' _ 1 't I�"I~t ONC. ago 51,00" 90'09'00" At,luoz pun SuIpIInAFn„ 50.00' uFNo Lpeafl at, eli� }o ,43i- HOZ 4 TENru ( 40' R 1W ) STREET J . RWNEY S1 SONS 136--1 �Gg�vWAr AVENUE t JACKSONVILLE, FLORIDA. 32206 , 100+1. 607• 6907' "CI�Lft(35SCYATIjy 110 T1JV1'.S"1T)125 °;AVIr(:ti I'Ah1K t ('I II CAM I'l17F ♦ar I•.1 •.. . twt r/u t�.wea w t nwi aM et+wet �trruntAner[N Wrlt wiatasu +�7'w a�wi t!t►trr; i i City of Atlantic Beach APPLICATION NUMBER �s r Building Department (To be assigned by the Building Department.) t 800 Seminole Road Atlantic Beach, Florida 32233-5445 EmolJ L,J Phone(904)247-5826 • Fax(904)247-5845 (� E-mail: building-dept@coab.us Date routed: 1 Z City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Addr*ss: J cS I d — Department review required Yes No uiIdin Applicant: )l R)—TU130 �S arming &Zoning Tree Administrator Project: E�M o lAo os(s�7 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 O 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: RJApproved. ❑Denied. ❑Not applicable (Circle one.) Comments: BUILDING _ / PLANNING & ZONING Reviewed by: •w ate: 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 05/19/2017 PUBLIC UTILITIES PLAN REVIEW COMMENTS Date: C' ('1 Application#: O 1'D OZS Project Address: 3 S 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 Utliitles needed,call 247-5878. Meter Boxes Ensure all meter boxes,sewer cieanouts and valve covers are set to grade Sewer Cleanout and visible. ❑ ❑ A sewer cleanout must be installed at the property line. Cleanout must be Cleanout Sewer covered with an RTI concrete box with metal lid. Cleanout to be set to grade 13 C3Cleanout 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. Pians 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. 13Requirement Fire Line Rre lines 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 See attached Utility Map. ❑ ❑ Disconnect &Cap Disconnect and cap water and sewer lines. C3 Inspection Must call the inspection Line at 247-5814 to request an inspection of the Price' disconnected and capped water and sewer lines prior to demolition. © ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ City of Atlantic Beach APPLICATION NUMBER �s Building Department (To be assigned by the Building Department.) ' 800 Seminole Road /� �r Atlantic Beach, Florida 32233-5445 lJ Phone(904)247-5826• Fax(904)247-5845 �Jfi qY E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: J l0� 0 — �� Department review required Yes No uildin Applicant: (ZY(.,(3Q Qj�_S anning &Zoning Tree Administrator Project: ��LO L(00S 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 ,rl Other: lJ APPLICATION STATUS Reviewing Department First Review: Q pproved. ❑Denied. []Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: l TREE ADMIN. Second Review: []Approved as revised. ❑Deni ❑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 OFFICE COPY Doc#2019204834, OR BK 18920 Page 1750, Prepared by and return to: Number Pages:2 Nolan Winarchick Recorded 09/06/2019 10:53 AM, Ponte Vedra Title, LLC RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL 50 AIA North,Suite 108 COUNTY Ponte Vedra Beach, FL 32082 RECORDING $16.50 DEED DOC ST $3920 00 File Number 19-1760 (Space Above This Line For Recording Data) Warranty Deed This Warranty Deed made this 28th day of August, 2019, between Matthew D. Duffy and Sydney K . Duffy, husband and wife, whose post office address is 400 La Reserve Circle, Ponte Vedra Beach, FL 32082, grantor, and FaverGray Homes, LLC, a Florida Limited Liability Company, whose post office address is 415 Pablo Avenue, Suite 200,Jacksonville Beach, FL 32250,grantee: (Whenever used herein the terms "grantor" and "grantee" include all the parties to this instrument and the heirs, legal representatives,and assigns of individuals,and the successors and assigns of corporations,trusts and trustees) Witnesseth, that said grantor, for and in consideration of the sum of TEN AND NO 100 DOLLARS ($10.00) and other good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged, has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land, situate, lying and being in Duval County,Florida,to-wit: Lot 30, Block 13, PLAT NO. 1,SUBDIVISION "A" ATLANTIC BEACH, according to the plat thereof, as recorded at Plat Book 5, Page 69,of the Current Public Records of Duval County, Florida. Parcel Identification Number: 170085-0000 Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining. To Have and to Hold, the same in fee simple forever. SUBJECT TO covenants,conditions, restrictions,easements of record and taxes for the current year. And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the grantor has good right and lawful authority to sell and convey said land; that the grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances,except as specified herein V� / 0 — Warranly Decd Page t of 2 Mf9Q96P� OFFICE COPY In Witness Whereof,grantor has hereunto set grantor's hand and seal the day and year first above written. TWO DIFFERENT WITNESSES HAVE SIGNED BELOW(THE NOTARY MAY BE ONE OF THE WITNESSES)AND NEITHER WITNESS NOR THE NOTARY IS RELATED TO THE GRANTOR OR HAS A BENEFICIAL INTEREST IN THE SALE OF THE PROPERTY DESCRIBED IN THIS WARRANTY DEED. Signed,sealed and delivered in our presence: Wi e tSignatu —_ urnm�r y1t Matthew D.Duff Witness I P ' ed Name itness 2 Signature Sy0ey K.D Herbert W. Reynolds Witness 2 Printed Name State of Florida County of St.Johns The foregoing instrument was acknowledged before me this 23rd day of August,2919,by Matthew D.Duffy and Sydney K.Duffy,husband and wife,who(_)are personally known to me or( have produced G I as identification. N TARY PUBLIC Printed Name: Am My Commission Expires: NowHerbert PubNc Stft of Fkxft ,T Nerberi W Reynolds anM' ggkesoeit3ft.13 X38 Warranty Deed Page 2 of 2