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1270 Ocean Blvd DEMO20-0002 Int Demo �S''"'''r,,�, DEMO PERMIT PERMIT NUMBER uS ' ` DEM020-0002 �- CITY OF ATLANTIC BEACH ,r 1 800 SEMINOLE ROAD ISSUED: 2/3/2020 1.-`'1 ~ ATLANTIC BEACH. FL 32233 EXPIRES: 8/1/2020 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: 1270 OCEAN BLVD DEMO INTERIOR ONLY INTERIOR DEMO $1000.00 TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 171823 0000 MANDALAY COMPANY: ADDRESS: CITY: STATE: ZIP: Eastern Shores 1015 Atlantic Boulevard #240 Atlantic Beach FL 32233 Construction OWNER: ADDRESS: CITY: ' STATE: ZIP: STONE MITCHELL A 1270 OCEAN BLVD ATLANTIC BEACH FL 32233-5742 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. i E FEES -� u DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT DEMOLITION 455-0000-322-1000 0 $100.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $104.00 Issued Date: 2/3/2020 1 of 2 - BuildingPermit Application DCAn.c) zpd�o� �o z L .,„., �:� p p City of Atlantic Beach Building Department **ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY ,,,,,,,,_-;.,",/ ra IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: 12"1 0 c LII4✓` 3 ( 3 Permit Number: 1 1 ( 4b L 3 - 000 0 Legal Description � .CILZ� C k) ZS Pl.. L©4 Lt S _ 3 7�E en f { � Heated Cooled SF/ Non-Heated Cooled Valuation of Work(Replacement Cost)�'rC�(� / Heated/ Cooled �� • Class of Work: ❑New ❑Addition ❑Alteration ❑Repair❑Move Rmo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial LgResidential • If an existing structure, is a fire sprinkler system installed?: ❑Yes NIC • Will tree(s) be removed in association with proposed project? EYes(must submit separate Tree Removal Permit) Flo Describe in detail the type of work to be performed: Florida Product Approval# i 1/tc for multiple products use product approval form Property Owner Information ` .- Name VA 1 A(,I,. L!, L GV i . S CV '�.4- Address 171 o 0 LAG"' t.J Z City l i.- C i.v.c_ State VI- Zip 3 t2..,3 Phone C 61- 5 j' ev5 o ., E-Mail Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information �f Name of Company t t )k{2.1^ S k a ;01 t"... `'1;-,t/[1/.. Qualifying Agent \(.4 9<1'y 1....42.;-f 2....0„ ZJ 2A - - Address i u 1 i �` 'Y , I1 J. 5-_.'4'- 2-'- T/ City kV1,:,_i-i. i3C,.., State R Zip 7 Z Z 3 S Office Phone CIO-1 _ <`1 g'- n ti-ti4 Job Site Contact Number C'(xvAi-- State Certification/Registration# t- 13•-•b S i I i.3 E-Mail 1 Q ,n rL 8 2 A1$0.,At, . JLs..(r Architect Name&Phone# ^/),N> Engineer's Name&Phone# i /t>'C Workers Compensation Insurer N/b OR Exempt xpiration 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 FINA , G, CONSULT WITH YOUR LEN R OR AN ATTORNEY BEFORE RECORDI G YOU '.-' 'TICE OF COMMENCEMENT. . \�---"' (Signa ure of Owner or (Signature of Contractor) �' ed and sworn to(or a fir r before - this day of Sign nd sworn to(or a •d) -•fore a this _ day of ," ___2.C3 • A (A r� i Ill)r rr .2CDl `� r�-, it opa kiginWli .4 '�!'!e"''•. TONT GINDLESPERGE' (Si: '- - o �1'bta i� Si: . ire a Notary / ,, „,, MY COMMISSION#GG 353178 m'•.WW-zi EXPIRES:October 6,2023 "''•'.'Fdf;TI IMWthrbeilitidentrrReriersonally Known OR ;1,o"•"•°ak:., TONI GINDLESPERGER ,•, • MY COMMISSION#GG 353178 - ••• -• •- - [ ]Produced Identificati. -- i-,._ EXPIRES:October 6,2023 Type S 3 CJO-' I Z --62.-;70c/ °T a of Identification: ----;;.•%4. : ' T e of Identification: YP ( ._ . .