470 Garden Ln DEMO21-0023OWNER:ADDRESS:CITY:STATE:ZIP:
IVINS THOMAS J 470 GARDEN LN ATLANTIC BEACH FL 32233-4528
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
172020 5220 SELVA MARINA GARDEN
02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
470 GARDEN LN DEMO PARTIAL
REMOVAL OF NON
PERVIOUS MATERIAL FOR
CREDIT
$2000.00
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.
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.
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.
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.
1 of 2Issued Date: 7/30/2021
PERMIT NUMBER
DEMO21-0023
ISSUED: 7/30/2021
EXPIRES: 1/26/2022
DEMO PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
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
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 REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
7 PUBLIC WORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking and debris must be removed from job site by Owner.
8 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Owner.
2 of 2Issued Date: 7/30/2021
PERMIT NUMBER
DEMO21-0023
ISSUED: 7/30/2021
EXPIRES: 1/26/2022
DEMO PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $129.00
DEMO21-0023 Address: 470 GARDEN LN APN: 172020 5220 $129.00
BUILDING $100.00
DEMOLITION 455-0000-322-1000 0 $100.00
PUBLIC WORKS PLAN REVIEW $25.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R16472 $129.00
Printed: Friday, July 30, 2021 9:08 AM
Date Paid: Friday, July 30, 2021
Paid By: IVINS THOMAS J
Pay Method: CREDIT CARD 489438259
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R16472
1
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
(904) 247-5800
BULLETIN 4-18
To: All Permit Applicants.
From: Dan Arlington, CBO
City Building Official
Date: October 30, 2018
Re: DEMOLITION OF STRUCTURES.
Please use the general Building Permit Application Form for Demo Permits and include a Site
Management Plan, showing all structures to be demolished and to remain, erosion and sediment
control plans with installation details, proposed use of the right-of-way and parking; a property
survey; and the contractor’s documents needed to obtain a building permit.
1. It is the responsibility of the contractor to:
a. Contact JEA to disconnect electric power.
b. Disconnect and cap off water, sewer, and gas lines. The contractor must call to
schedule an inspection of the disconnected and capped water and sewer lines prior to
demolition.
c. Start a Construction Water Account. (See Items 8 – 11 on Page 2)
2. The demolition contractor must provide written notice to the owners of all adjacent
properties, not less than 10 Days prior to start of demolition, per FBC-EB, Section
1502. Adjacent properties must be protected from damage during excavation,
demolition, and construction activities.
3. Silt fences must be in place and approved by Public Works before beginning
demolition.
4. All underground tanks, concrete slabs and foundations must be removed with the
buildings, unless otherwise approved by the City. The site should be left graded and
clean for Final Inspection.
5. Removal of any trees requires a separate Tree Removal Permit, per COAB Code
Of Ordinances, Section 23-21.
2
6. Protection of trees and vegetation during construction is required, per COAB Code
Of Ordinances, Section 23-32.
7. Prior approval, from the Building Department, is required before blocking any part of
the right-of-way or side walk.
Dust and wind-borne debris generated from the demolition of a structure is considered
unsafe and a hazard to the public health, safety, and welfare of residents in the
surrounding areas.
When demolishing a structure, the following steps are required to ensure that the
minimum dust and debris leaves the property:
8. At least two hoses, with nozzles, capable of reaching to all areas of the property must be
on site with an adequate water supply.
9. The structure must be sprayed with water for one hour before demolition begins.
10. The hoses must be used continuously during demolition, wetting down the structure, the
debris pile, and truck beds when being filled.
ASBESTOS.
11. All roofing and siding made from asbestos containing materials (ACM) are considered
friable and must be removed from the structure, following NESHAP Guidelines, before
demolition begins. This includes all commercial and one and two family residential
dwellings.
Please call for a Pre-Demolition Inspection, before demolition begins, and a Final
Inspection, when demolition is complete.
NOTES.
1. A construction water account can be obtained at the Water Department in City Hall.
2. Any new residence using the original building sewer piping shall be internally examined
to verify correct size, slope, is not broken or obstructed, and a clean out at the property
line with an RT-1 concrete cover is required to comply with current City requirements.
10/30/18, 12/28/18, 10/23/2020
Final Plumbing
Final Electrical
Final HVAC
CC Final
Final Building*
Swimming Pool Steel
Swimming Pool Safety
Electrical Grounding & Bonding
Swimming Pool Final (Bldg)
Swimming Pool Final (PW)
Formed Columns/ Beams*
Masonry Cell Fill
Structural Steel*
OTHER:
OTHER:
OTHER:
OTHER:
OTHER:
Power Pole
Silt Fence
Piers/ Stem Walls
Underground Plumbing
Underground Electric
Foundation/ Footing
Slab**
Retaining Wall Footing
Driveway
Sewer (Building Dept)
Sewer Tap (Utilities Dept)
Rough Electric*
Rough Plumbing/ Top Out*
Rough Mechanical*
House Wrap
Wall Sheathing
Roof Sheathing
Tie-down Framing Connections
Rough Framing
Roofing In Progress
Window/Door In-Progress
Insulation Ceiling
Insulation Wall
Exterior Lath
Stucco Scratch Coat
Exterior Siding In-Progress
Brick Flashing & Ties
Early Power
Gas Rough
Gas Final*
* When all rough electric, plumbing, mechanical are complete but before any work is
covered up.
* When all gas piping is complete and wallboard is installed but before gas is
attached to any appliance. All outlets must be capped and pipe pressurized at a
minimum of 15 lbs.
* For new living space: When all construction work including electrical, plumbing,
mechanical, exterior finish, grading, required paving and landscaping is complete
and the building is ready for occupancy, but before being occupied
Additional inspections may apply to your project if your project
contains these elements:
INSPECTIONS REQUIRED FOR BUILDING PERMITS
To verify compliance with building codes, inspections of the work authorized are required at various points of the construction.
The following inspections are typically required for residential projects:
Date: Initial: Date: Initial:
_____________________________________________________
Permit Type
____________________________________________________
Permit No.
__________________________________________________________
Job Address
____________________________________________________
Contractor
POST THIS CARD WITH PERMITS AND PERMIT
DOCUMENTATION IN FRONT OF BUILDING
Construction Hours per City Code: 7am—7pm Weekdays; 9am—7pm Weekends
Building Department Public Works/Utilities Fire Department
Phone: 904-247-5826 Phone: 904-247-5834 Phone: 904-630-4789
Fax: 904-247-5845 Fax: 904-247-5843 Fax: 904-630-4203
* When forms and reinforcing steel, anchor bolts, sleeves and inserts, and all
electrical, plumbing and mechanical work is in place, but before concrete is poured.
* When all structural steel members are in place and all connections are complete,
but before such work is covered or concealed.
** FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION
v-'N, Building Permit Application Updated l0/9/18
City of Atlantic Beach Building Department ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
t;s191
IS REQUIRED.
Phone: (904)) 247-5826 Email: Building-Dept@coab.us
Job Address: 4-70 64 Ofiv LANE- Permit Number:
Legal Description 3.~3 1 61 -2S -Z1L 5{0{4- MN C -4r'0TL Loc1c)RE# 17Zo 20 52.2o
Valuation of Work(Replacement Cost)$ Zt oUU Heated/Cooled SF Non-Heat t•,•C
Class of Work: New Addition Alteration Repair Move Aemo Pool Windo oor
JUL 14 2021
Use of existing/proposed structure(s): Commercial Vkesidentia``l
If an existing structure, is a fire sprinkler system installed?: Yes L No BY'
Will tree(s) be removed in association with proposed project? Yes(must submit separate Tree Removal Permit) . JNo
Describe in detail the type of work to be performed:. e `:Quf t_ G F ('Jo r- - Pt2vta.. L4,<.,.) 4zir._
cue- G- C O ii- c 4e.0 S fl, *-,--;-...r-.>re._ Qcw\ I r.) • 1! 4$`7\ .
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name -TitbitsS --5- . \V1NAddress 4-77 6f Dom,/ (mac` ,
City 1 t.c T\L V 2P-C-Ft State ft Zip ZOE- 53 Phone 6,0.1. -14"1 - G7CcLn
E-Mail '-i 3 1 J't.J& e__ GNaLc -v-
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information — Ni/p\---
Name of Company Qualifying Agent
Address City State Zip
Office Phone Job Site Contact Number
State Certification/Registration# E-Mail
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt 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 FINANCIN , CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
REC' • • Or. YOUR N" ICE OF COMMENCEMENT.
rii
Signature•f• ner or Agent)Signature of Contractor)
ned`and sworn to or a firmed)before m- th' / say of Signed and sworn to(or affirmed)before me this day of
202 (, • a. •f vi , ss, by
VIIIINIMES
tures .t'
R Signature of Notary)
AI
t'';''oy'', TONI GINDLESPER
Personally Known OR a°' `:c so Ily Known OR
T MY COMMISSION#GG 3 I
Produced Identification rodu •d Identification
EXPIRES:October 6, i
Type of Identification:7...6 t licun witg, •ntification:
DEMO21-0023
BOUNDARY SURVEY
P PLAT LIMITS
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SURVEY NOTES
CONCRETE
C-1 R=25.00'
ON SOUTHERLYBIDE OF LCROSSIOT.
NG INTO RAN L=9.94'
THERE ARE FENCES NEAR THE BOUNDARY A=22°46'49"
OF THE PROPERTY.
TARGET
No.s41s ' SURVEYORS CERTIFICATE
I HEREBY CERTIFY THAT THIS BOUNDARY SURVEY
wIS A TRUE AND CORRECT
R
REPRESENTATION OF A SURVEYINGSURVEYPREPAREDUNDERMYDIRECTION.
NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC
STATE OF SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL, LB#7893
OR A RAISED EMBOSSED SEAL AND SIGNATURE.
Digitally signed by SERVING FLORIDA
Kenneth J.Kenneth J.Osborne 6250 N.MILITARY TRAIL,SUITE 102
Date:2020WEST PALM BEACH, 33407
SIGNED) ----
Osborne 19:43:47-04'004'00'' PHONE (561)6404800
STATEWIDE PHONE (800)226-4807KENNETHJOSBORNEPACF2PACFS
I)
STATEWIDE FACSIMILE ( 800)741.0576PROFESSIONALSURVEYORANDMAPPER#6415 NOP L
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I WEBSITE http://targetsurveying.netm.,,,. ,,
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DEMO21-0023
s'-,L'--,& Owner Builder Affidavit ALL INFORMATION
sr., HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
T.' ryI9.r
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES
OWNER/BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED
FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER
OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A
LICENSE.
YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF.
YOU MAY BUILD OR IMPROVE A ONE OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY
ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS.
THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE
CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH
IS IN VIOLATION OF THIS EXEMPTION.
YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS.
IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES
REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES.
II. INJURY LIABILITY;SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,THE BUILDING DEPARTMENT
SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. .
III. IRS WITHHOLDING;OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING
TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT
TO$5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE
OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY" OR THE FLORIDA"CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904-
247-5826 OR BUILDING-DEPTPCOAB.US) IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I
COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
Job Address: 1-76 6 feof,.) L Lt>1\\-1c V2CAok "Flc•e,C 2-2- ?"
Owner Name: 'rn{acr.frs7. IV INS Phone Number: Cp09 " X11 '
0GSS\
Mailing Address: `F 70 G PQ,0f4., j vQ City: ATIdwat L.. 6E.A. 14 State: FL_ Zip: 32-Z 23
Notarized Signature of Owner A
tet?
T e[-foc oin in trument was acknowleged before me this / ' day o _ 2R- I , in the State of Florida, County
11)
Signature of Notary Public _ C -
Personally Known OR [ ] Produced Identification 1
Type of Identification:h,
Updated 10/24/ 18
TOM GINDLESPERGER
r1, ':, MY COMMISSION#GG 353178
EXPIRES:Cctoher 6,2023
t 'O,Fk°'' Bonded Thru NotaryPublic Underwriters
DEMO21-0023