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2236 Barefoot Tr DEMO20-0035 Drywall ,.dirfA DEMO PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH DEMO20-0035 " 800 SEMINOLE ROAD ISSUED: 12/1/2020 � V ATLANTIC BEACH, FL 32233 EXPIRES: 5/30/2021 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: 2236 BAREFOOT TRACE DEMO INTERIOR ONLY DEMO - DRYWALL $1000.00 TYPE OF REAL ESTATE BUILDING USE I ZONING: SUBDIVISION: CONSTRUCTION: I NUMBER: GROUP: 169463 0588 OCEANWALK UNIT 02 COMPANY: ADDRESS: CITY: STATE: ZIP: PHILLIPS BUILDERS LLC 1250 SELVA MARINA CIR ATLANTIC BEACH FL 32233 OWNER: ADDRESS: CITY: STATE: ZIP: MONS NARAYAN C 2236 BAREFOOT TRCE ATLANTIC BEACH FL 32233-4564 WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT II` 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. 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:12/1/2020 1 of 1 Cash Register Receipt Receipt Number 'IL City of Atlantic Beach R14246 PermitTRAK $104.00 DEMO20-0035 Address: 2236 BAREFOOT TRACE APN: 169463 0588 $104.00 BUILDING $100.00 DEMOLITION I 455-0000-322-1000 0 $100.00 STATE SURCHARGES $4.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 $1s Date Paid:Tuesday, December 01, 2020 Paid By: PHILLIPS BUILDERS LLC Cashier: CG Pay Method: EMV 1491131399939345 Printed:Tuesday, December 1, 2020 11:43 AM 1 of 1 ',o; CENTRALSQUARE Building Permit Application Updated 10/9/18 47*._ City of Atlantic Beach Building Department **ALL INFORMATION \ . ,� 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY -�xijIS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: 2.23(0 P?Ak C ran TRAM 32233 Permit Number: �`m��Z��i✓� Legal Description 44. • 13 6--25 -ZIC OC.EANA1K Lt4iTZ t.c`-r '/3 RE# I'(Oery(03 - 056B Valuation of Work(Replacement Cost)$ i•poQ Heated/Cooled SF Non-Heated/Cooled • Class of Work: ONew ❑Addition DAlteration ❑Repair ❑Move XDemo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial VResidential • 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) GS(No Describe in detail the type of work to be performed: LITC DEMO / eEtitvVE D17,4v.1A,\1 ErivOt.E2 Florida Product Approval# for multiple products use product approval form Property Owner Information Name CHft1S MOIQS Address L23(o %/NICE Fcx5 "ORALE City A. (j State r I Zip 32 Z 3 3 Phone 904 -SOLI ' (090t1 E-Mail NC MC r.)S `/H H10• cv Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company Pail i'P5 Qualifying Agent IZIaQP,(l-Pf ?4§.(1 113.5 Address 'lel Z CSC ERnI '\‘.1 ) City A. State F \ Zip '3ZZ 33 Office Phone goy - 3ti9 - cievv% Job Site Contact Number 9oq - 7557`)9yB State Certification/Registration# C($(, t 2`S 7E-Mail 'P1-•c\\SP5 61.)%k OEig-S Q . Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Insurer OR Exempt Q( 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 A ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. / %• /,, , (Signature of Owner or Agent) (Signatu of Contractor) Si ned and sworn to(or affirmed)before me thi V day of SiKed and sworn to(or a d)b:fore met or •ay.' -r, , by k / r Q\Q u. V "Dv' 3 L J� t; ,�02 0, W&i 1 i.� .� AdI a7 n_ (Signatur-of Notary) ig R! � - ----- " 1'PersonaIIvKnowrlIDOLPH Personall Known OR TONI GINDLESPERGER RersonallyKnow [ ] y#GG 15571 �� MY COMMISSION#GG 353178 Produced Identifi [ ]Produced Identification ....rua 19,2022 �� EXPIRES:October 6,2023 Type of Identificatiory Type of Identification: •,'rF P; ,,, tionaea i hruNotary PuIic Underwriters .wa