1753 E Park Ter DEMO20-0009 House/Driveway DEMO PERMIT PERMIT NUMBER
1.t DEM020-0009
CITY OF ATLANTIC BEACH ISSUED: 3/6/2020
800 SEMINOLE ROAD
rili1! EXPIRES: 9/2/2020
ATLANTIC BEACH. FL 32233
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:
1753 E PARK TER DEMO COMPLETE HOUSE & DRIVEWAY DEMO $12000.00
EXCEPT POOL
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0410 SELVA MARINA UNIT 08
COMPANY: ADDRESS: CITY: STATE: ZIP:
FASANELLI CONSTRUCTION
INC 5150 Palm Valley Rd #305 Ponte Vedra Beach FL 32082
OWNER: ADDRESS: CITY: STATE: ZIP:
PETERSON ALIZA 520 MORNING SIDE DR PONTE VEDRA FL 32233
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.
Issued Date: 3/6/2020 1 of 3
s
�S"�','rr' DEMO PERMIT PERMIT NUMBER
r Wyk' DEMO20-0009
ysi
r CITY OF ATLANTIC BEACH ISSUED: 3/6/2020
7,...
J,; ,� 800 SEMINOLE ROAD EXPIRES: 9/2/2020
ATLANTIC BEACH. FL 32233
2 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
3 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL
Notes:
Roll off container company must be on City approved list. Approved list can be obtained at the Building Department at City Hall. Roll off 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.
6 PUBLIC WORKS GRASS INFORMATIONAL
Notes:
Full site to be grassed.
7 PUBLIC WORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking and debris must be removed from job site by Contractor.
8 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL
Notes:
Pool must be protected with fencing.
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:
MUST CALL the Inspection Line at 247-5814 to request an inspection of the disconnected and capped water and sewer lines prior to demolition.
12 PUBLIC UTILITIES ADDITIONAL COMMENTS PUBLIC UTILITIES INFORMATIONAL
Notes:
All water&sewer utility connections must be inspected prior to cover up. Please call the inspection line at 247-5814 to schedule inspections 24
hours in advance.Failure to do so will result in future failed inspections and additional fees.
FEES
Issued Date:3/6/2020 2 of 3
1.d-V'f4.' DEMO PERMIT PERMIT NUMBER
,sy ' ' DEM020-0009
ov ) CITY OF ATLANTIC BEACH ISSUED: 3/6/2020
800 SEMINOLE ROAD
'-`D;i19%. ATLANTIC BEACH. FL 32233 EXPIRES: 9/2/2020
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:3/6/2020 3 of 3
; Ai7 City of Atlantic Beach APPLICATION NUMBER
j,, Building Department (To be assigned by the Building Department.)
1-• \� 800 Seminole Road \Jo000
',' Atlantic Beach, Florida 32233-5445 ��
Phone(904)247 5826 Fax(904)247 5845 /•,C
;.%�RiJr E-mail: building-dept@coab.us Date routed: �`/ [� Z U
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I 75 3 1 4I-2K t C�� Department review required Yr- No
uildin
Applicant: 1-----(a cj f_\. ND� .A.,( 0 t S� Planning &Zoning
ll Tree Administrator •
Project: Imo`00,S ` JPAV t.-1R0- crigublic Wo_r s
ublic Utilitie_
L-€:---Pc VE (app c— 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:
APPLICATIONLISTATUS
I
Reviewing Department First Review: kApproved. I 'Denied. nNot applicable
(Circle one.) Comments:
:UILDIN p/ /
PLANNING &ZONING Reviewed by: Date: J ! y zo
TREE ADMIN. Second Review: 'Approved as revised. Denie� Notapplicable
pp I � n
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. I 'Denied. I Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
City of Atlantic BeachF'LC'8 APPLICATION NUMBER
Building Department ?s apo (To be assigned by the Building Department.)
i 800 Seminole Road ay. �U Th o z 0:_vQ p").,..- r� Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 _E-mail: building-dept@coab.us � Date routed: 2^/2-57Z 0
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 175 3 JA 2tc�C—� Department review required Yes No
(— �uildir1g.�
Applicant: I— (a 1N__)-eC.(.l C .� .S; Planning &Zoning
Tree Administrator
jj
Project: Imo\OIJS C PAN) C/yj"Crublic�or s
ublic Utilitie
VG- PDC) c__ 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: ✓(Approved. I !Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by li Date: ,Z
- 64
TREE ADMIN. Second Review: I '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
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
A F'l 800 Seminole Road EM 0 Z-0 _0DO')
j._ Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
1.011 qP E-mail: building-dept@coab.us Date routed: Z12---
City
12City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I '75 3 Ppc1eta.. 1 . Department review required Yes No
F—A
Applicant: �tJ�(,l Q(�5 Planning &Zoning
l Tree Administrator
Project: `00S E r2lV C-In ublic Wor
ublic Utilities
R (_ pPublic 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:
APPLIC ON STATUS
Reviewing Department First Review: pproved. Denied. Not applicable
(Circle one.) Comments: Sea-
SHEET
BUILDING
PLANNING &ZONING
Reviewed by: Date: 7-2 `3-243
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: Application #:
Project Address:
Check Box Check
APPLICATION TRACKING COMMENTS to Add Box to
Commen 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 Backflow be provided or if there is a private well on the property. Backflow preventer ❑ ❑
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 Sprinkler If fire sprinkler system is provided, call 247-5878 for backflow requirements.
Backflow 0 0
At a minimum,will require a double check backflow preventer.
Requirement
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.
0r7 ❑
v7
Disconnect
& Cap Disconnect and cap water and sewer lines.
IZ7Inspection 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.
Utility All water& sewer utility connections must be inspected prior to cover up.
Inspections Please call the inspection line at 247-5814 to schedule inspections 24 hours in
advance.
System All fees must be paid for water& sewer connections before meters will be set.
Development Please call the finance department customer service line 247-5816 to 0 0
Fees coordinate payment of fees.
0 0
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'I="'''•,,, Building Permit Application Updated 10/9/18
1� jCity of Atlantic Beach Building Department **ALL INFORMATION
\ 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
mum:), IS REQUIRED.
/Phone: (904) 247-5826 Email: Building-Dept@coab.us /�
Job Address: .7 S 3 r ,y ?GA GE E.45.� / /Permit Number: L �IDZV- Ooo
Legal Description LOT 7, 3L OG,(/ /I/ --.61.1/A1--/�/ifA1/ uNir 8 RE#
Valuation of Work(Replacement Cost)$ /2, e2 OO '6'. Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration DRepair ❑Move ,XDemo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial CI Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes No
• Will tree(s)be removed in association with proposed project? DYes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed:
COMPLb Pere- c7 -i,-,ba of h/ovsvr ¢ PA/i/bw4• '/s'Dtr-,✓�c." . o0 - Lai c.c,
Florida Product Approval# for multiple products use product approval form
Property 9wner Information AA �^
Name G /24 /'b3Z-/ 544) Address 52 0 /1104.-A,14.2‘ b- Jic'DP•li✓1
City ?AIM- ✓f1V/t4- gb14GH State PL. Zip 32- 082 Phone 9Oe/-302-3 7,y
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information 7.--74-E310
��''
Name of CompanynF/i-5,4•ag2L% Cods, i& /?a0ht Quali ing Agent 7.--8%O i ^9.541-✓6LL%
Address$/SO p�Lr/ 1ALL2 ' k)7130.5 city Pi/13G-p-Li+ State P - Zip 32(3.02
Office Phone 7OV Z23— 3 OOZ Job Site Contact Number TO.,+AL) t/3,'m ,.. 90y-tv3/-S4' /
State Certification/Registration# C&C 034/232 E-Mail F0..15/0 F/•/SAmv-LL%C eZJsfhv'2AJ• G O.—t
Architect Name&Phone#
Engineer's Name& Phone# ,f
Workers Compensation Insurer $ /V/i.0&71.s 7V7-1Jiit- sic Co OR Exempt ❑ Expiration Date 2'24.-2 67
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 additi rats cf
permit,there may be additional restrictions applicable to this property that may be found in the publi c f t grin a 1
there may be additional permits required from other governmental entities such as water management istrriicts,�t agencies,g`enc es,or
federal agencies.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in corfibOnr iiitp(po
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMEEMEIT..Ment
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY -If-YOU INTEN,Qt., -tN
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
REC RDING3UR NOTICE OF COMMENCEMEN J.,_________
ignature of Owner or Agent) ( (Signature of Contractor)
Signed and sworn to(or affirme,f�)before mgthis day of Signed and sworn to(or affirmed)before me this day of
ILIA
FL33 , .201-0, b ff Li 2,. /err c SO(�.1/ FC73 , 2020,by Ai zo r- 5, sJJ2-c. j
i �L = I _ \r -� •
(Signatur• ,f otary
Notary Public Stabs of Florida
Tracy R White .403%. Notaxy Pubic Slabs d Florida
GG 9149'Si
Xersonally Known OR '� of My [ ersonally Known ORly M,Commission OG 91,E
[ ]Produced Identification d [ ] Produced Identification Vat Emirs 09119/2023
Type of Identification: Type of Identification:
-bnc)7_0-- 000
NOTICE OF COMMENCEMENT
State of Ft1 Tax Folio No.
County of
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and°int accordant with Section 713
of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. F
Legal Description of property being improved: 1...07 7 8L o c-1/ iy, SEL f/a MA-wt 1.414 CIA %r s' 8
5 6604,0 el, /N P8 3N/ 1940c 85 GPS Dw41- /Cm�.✓ry/�2 0/1 P.4
Address of property being improved: /7 53 ,A2A/ T nge...er L/; $T- grit-A1,"1-3-6- BeA
General description of improvements: DeYY.OG/r o,J off% Ex/5 vc r.'-v ,&p
Go# 5AAT2tcno,a OF /.)en‘, 5/,J z-s-/ SES/Dery G �
Owner: /fL /24 fferg i,S OA) Address: 520 Mo,:Lsts/v' - S/"p6- Vit. J pv /2:';208
Owner's interest in site of the improvement: /t 2 $,•.i PG cs
Fee Simple Titleholder(if other than owner): 1'4 A _
Name:
Contractor: /" ;"rj/. ) 7_i /n C 7, J$p- �?GTloa .�wi9G . _
Address: �S'i S O Y.dLwi VA-LG e y Ro ,,.�OS V a P" . 3z
Telephone No.:9011-2 .30v C
z3- 2- Fax No: 7 Oy-2-Z3.3O 7 S
Surety(if any) /A
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name: N/A
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: N-1 /A
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: N [A
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
Doc#2020057514,OR BK 19135 Page 1791, Signed:X Date: -2 LI-2021)
Number Pages: 1
Recorded 03/11/2020 01:31 PM, Before me this s day of - ZLK_A., in the County of Duval,State
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Of Florida,has personally appeared A 140. 4'e,4-erc
COUNTY Notary Public at Large,State of Florida,County o P .
RECORDING $10.00 My commission expires: , C? - Notary Public Stated Florida
Personally Known: Tracy R VVhrte fpr
J9 Produced Identification: ME •
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