174 15th St DEMO19-0030 Home (---;,i..A.0„., DEMO PERMIT PERMIT NUMBER
� ; DEM019-0030
�Nr. s, CITY OF ATLANTIC BEACH
ir ISSUED: 12/13/2019
\ 800 SEMINOLE ROAD
".:Z•u':i�" ATLANTIC BEACH. FL 32233 EXPIRES: 6/10/2020
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:
174 15TH ST DEMO COMPLETE DEMO HOME $10000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171866 0000 MANDALAY
COMPANY: ADDRESS: CITY: STATE: ZIP:
MATHIEU BUILDERS 38 W 9TH ST ATLANTIC BEACH FL 32233
OWNER: ADDRESS: CITY: STATE: i ZIP:
MARCO DAVID A 2399 OCEAN BREEZE CT 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 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: 12/13/2019 1 of 2
,,0...44f7, DEMO PERMIT PERMIT NUMBER
r s •
• DEMO19-0030
v� CITY OF ATLANTIC BEACH ISSUED: 12/13/2019
800 SEMINOLE ROAD EXPIRES: 6/10/2020
ATLANTIC BEACH. FL 32233
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 UTILITY ROAD CUT INFORMATIONAL
Notes:
Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid 10 feet in each direction from the center of the
cut. Repair must be shown on the plans.\r\r\r\r\r\r
6 PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
7 PUBLIC WORKS SLAB DRIVEWAY REMOVAL INFORMATIONAL
Notes:
Slab and driveway to be fully removed.
8 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
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: 12/13/2019 2 of 2
t,A,y;..; City of Atlantic Beach APPLICATION NUMBER
e '. Building Department (To be assigned by the Building Department.)
A 'i 800 Seminole Road j"�
r.. Yf Atlantic Beach, Florida 32233-5445 IDG--- —0030
Phone(904)247-5826 • Fax(904)247-5845
p E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1`74- ISL-f-i`\: ( Depa tment review required Yes o
(`uilding }�
Applicant: I\A% rT T. k t C----u i.. U ((„,j3Ek... Planning &Zoning
Tree Administrator
Project: ____ 8,,_. `- -c Works
--clic Utilities.—
Public Safety
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
Reviewing Department First Review: Approved. HDenied. ❑Not applicable
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING
. Reviewed by: Date: Id -07 'dol
TREE ADMIN.
Second Review: El Approved as revised. I IDenie . ❑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
,-;:,--, .,,/,./ City of Atlantic Beach NOV 2 7 2019 APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
¢ .-'i 800 Seminole Road ID
r� Atlantic Beach, Florida 32233-5445 �Q� 003 0
Phone(904)247-5826 • Fax(904)247-5845 jJ
..r !PE-mail: building-dept@coab.us Date routed: I ( (2 '7 / ( 9
City web-site: http://www.coab.us (((
APPLICATION REVIEW AND TRACKING FORM
Property Address: l-74. I Sl� ( Department review required Yes No
(, Buildings
Applicant: V *T N t C() tL) ( Lb - S Planning &Zoning
•
Tree Administrator
______L
Project: ('�t )��(_ VVI eubjic Works •
Public Utiliti `' .
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: VApproved. ['Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Date
Reviewed b : //j/ /
i-i
TREE ADMIN. Second Review: A roved as revised.
n pp ['Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. nNot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
'1:) 800 Seminole Road 1�
Int — 3C�
4, Atlantic Beach, Florida 32233-5445
JPhone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: I ( /z.7 It 9
City web-site: http://www.coab.us -
APPLICATION REVIEW AND TRACKING FORM
Property Address: I-74 1 ( Depa tnt review required Yes No
l Ll ( Building
Applicant: I\\ R7 bit c.-1} RI)(1 ( Planning &Zoning
Tree e Administrator
Project: ` "` �. • is works
Public Utilities__..
Public Safety
Fire Services
Review fee $ Dept Signature
Review or Receipt
Other Agency Review or Permit Required 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:
APPLIC ON STATUS
Reviewing Department First Review: pproved. flDenied. Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed b Date: It - Z— /9
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied. nNot 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 Updated 10/9/18
''; City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
'#pr IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us 0/�
Job Address: 174 15th Street Permit Number: L)-E.f&( )I j -00
Job
Legal Description 10-11 16-2S-29E Mandalay Lot 14 BLK 620 RE# 171866-000
Valuation of Work(Replacement Cost)$lor npo e ' Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move 1Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ❑Residential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes ❑No
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed:
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name 7Z . Y "�CSA r C 0 Address Z_S k ct 0 c- ea K1 ✓e C e- CiL
City �} tf"(�t.� r,'c j �,�„ State��Zip 3 ZZ 3 3 Phone ¶ 6(1) 6/ 3 • S ...STS—O
E-Mail d..."0.r•CO Q1,1-‘ca../"C O - C o m
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information // / `—�
Name of Company y-A. s /`�,�,t,h/erf/z c, Qualifying Agent 4 5/.n i*-d e✓i-k
Address 3 0 W ?f1, SF City f]#/qq %c. / *L,k State F-- Zip 3 2-z 53
Office Phone •lA Job Site Contact Number eie tt 6,(3 36 G
State Certification/Registration#CB-/24-7S$6 E-Mail Du ST/nr((MAT'{ (A u ,O1 1.061ZS. C.-6 IA,
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer /44 - OR Exempt) Expiration Date t-q
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no wor 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 WITHS76R ► = R OR AN ATTORNEY BEFORE
OEC.RDING YOUR NsTICE OF COMM • •CAME
Akcid „ay •
(Signature of Owner or Agent) (Signature of Contractor)
nn i
Signed and sworn to(or affirmed)before me this 2-) day of Signed and sworn t (or a4 med)be,for- me this u` •ay of
/\loJ. , • 01 < by _ It. i,.,.60--, l-'-. , )ff , iy ��, �0 tic , r-
r •, .•,l•V SON I Sika e of
t•^ Commission#FF 944133 ,
r
Expires December 16,2019 e -
[VI/Personally Known OR gip,; °` ao�d.aTM,T,oyFanM,�,�aeroaesrou 'ersonally Known OR , Napo'-, TONI GINDLESPERGER
[ ]Produced Identification [ ]Produced Identification *_ MYCOMMISSION; GG353178
Type of Identification: Type of Identification: : ; e0. ;o<= EXPIRES:Oclobere,2023
,,pn?•' BondsdThru Notary Public l,.lde„Tilers
PUBLIC UTILITIES PLAN REVIEW COMMENTS
Date: Application#:
Project Address:
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 Sewer Boxes Ensure all meter boxes, sewer cleanouts and valve covers are set to grade 0 0
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 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 Backflow
If fire sprinkler system is provided, call 247-5878 for backflow requirements. 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 ❑ ❑
Meter than 2" must be installed in a vault as noted in JEA specifications.
Utility Map See attached Utility Map. 0 0
Disconnect
& Cap Disconnect and cap water and sewer lines. //,
Inspection MUST call the Inspection Line at 247-5814 to request an inspection of the
Prior disconnected and capped water and sewer lines PRIOR to demolition.
❑ ❑
❑ ❑
❑ ❑
O 0
NOTICE OF COMMENCEMENT
State of Florida Tax Folio No.
County of Duval
To Whom It May Concern:
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 Description of property being improved: 10-11 16-2S-29E MANDALAY LOT 14 BLK 60
Address of property being improved: 174 15th Street
General description of improvements: Demo and New Construction of Residential Two Story Home
Owner: —7�at..u i a- IA4 ix-I`c o Address:L3 It 4 OC,ea,..1 egr c ejc Ct. 44,fic e,..4 FL 322,
Owner's interest in site of the improvement: D I.t.J ii c se'
Fee Simple Titleholder(if other than owner):
D
Name: 0
i—
Contractor: Mathieu Builders Inc tv)
O
Address: 38 W 9th Street Atlantic Beach FL 32233 c
F-
a_
5
Telephone No.: (904)813-3661 Fax No: a'- It
rn 0
<
Surety(if any) Y c0 Y
CO ow
Address: Amount of Bond$ ai rn_ o
Telephone No: Fax No: ti,_o w e-
Cf)N
N. N N VJ 0
Name and address of any person making a loan for the construction of the improvements " C E z
as 7)w�f
'E
Name: bzzp
o = a1)00w
Address: azceixoct
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
Signed: -,& ,t-.1_, /U - 5--- Date: 11/L5i2O1 9
Before me this// 26—#4`. day of NOIR 2 in the County of Duval,State
Of Florida,has personally appeared
DYANNE M.DAW50N Notary Public at Large,State of Florida,County of Duval.
NN+'�,r,
4 ' fi% My commission expires: I Ctv� L 1 ZO 1 1.
_,; A Commission#FF 944133
'l; �'i Expires December 16,2019 Personally Known: t� or
+?o%•�' Bonded 7A,Troy Fain tn�wenalCOJBS70t9 Produced Identification:
p 1PLOTTABLE ITEMS SHOWN.
30 ��40
SCALE:01" = 20'
15th STREET
40' RIGHT OF WAY PAVED PUBLIC ROAD
47,97' FIELD
48.02' FIELD 48.00'
g.FOUND MAO NAIL & '° 1.4' - - ='�� CONCRETE WALK 1.2'
DISC LB 3848 2.3' 4' WORD P1. ET CF FOUND MAO NAIL k I 9 0.9' t FOUND 1/2" IRON -- --
2.3' DISC
-
DISC LB 3648 d ^� PIPE L9 3848
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Cl1 ;III 1N 6 ��
• PIP
or
I 8.3' 14.0— vy
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—n� I
0.5'..... N.CONCRETE CAA pefer
X10.1' / \ I
o f I �� CONCRETE I
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9, LQT 1 S Q st ONE STORY Sroce
. a
.1.1 I of o MASONRY 10.8' 5.' Co W
...J < a �.$I d O = 5 RESIDENCE 1o.e' '° N LOT 13
D 0a; 0 Na. 174 t c'c CPETE O o,
D 0.
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Z • I a; r 8.1' OUT
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M 3 8.1• 7.51
.3' 24,1'
oc0 "' lj
a . I S'`""` LOT 14
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Jam. Y
moo; ll ITP•
-' . I 8 L O . 0 / 0.8' 6 C
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I (190 I
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3.5' D 0.74WOOD PICKET FENCE a'6, �� i 0.4'
FOUNO 1/2' IRON 48.00' FOUND 1/2" IRON—-- pp �y ' 8' NKIOD FI N. R -- —
PIPE, NO CAP PIPE NO CAP 4V.LO FouNO 1/2" IRCN
48.19' FIELD 48.06' HELD 0.1 PIPE. NO CAP
LOT 8
NOTES:
THIS IS A BOUNDARY SURVEY.
NO BUILDING RESTRICTION LINES AS PER PLAT,
ANGLES SHOWN ARE AS PER FIELD SURVEY.
! NORTH ARROW PROTRACTED FROM PLAT.
THIS SURVEY WAS MADE FOR THE BENEFI