HomeMy Public PortalAbout10-0424 SandersDATE ISSUED: 08 -19 -2010
WORK DESCRIPTION
WORK LOCATION
OWNER NAME
ADDRESS
CITY, ST, ZIP
PHONE NUMBER
CONTRACTOR NAME
ADDRESS
CITY STATE ZIP
FLOOD ZONE
BUILDING VALUATION
SQUARE FOOTAGE
OCCUPANCY TYPE
TOTAL FEES CHARGED
PROPERTY IDENTIFICATION #
PROJECT VALUATION
CITY OF TYBEE ISLAND
BUILDING PERMIT
REPAIR ROOF SHINGLES
5 EIGHTEENTH ST
B.E. & LORNA SANDERS
369 LANGSTON CHAPEL RD
STATESBORO GA 30458 -3773
912 -536 -3973
E C BURNSED CONST
109 BUTLER AVE
TYBEE ISLAND GA 31328
P
$ 50.00
$ 600.00
PERMIT #: 100424
TOTAL BALANCE DUE: $ 50.00
It is understood that if this permit is granted the builder will at all times comply with the zoning, subdivision, flood control, building, fire,
soil and sedimentation, wetlands, marshlands protection and shore protection ordinances and codes whether local, state or federal, including
all environmental laws and regulations when applicable, subsequent owners should be informed that any alterations to the property must be
approved by the issuance of another building permit. Permit holder agrees to hold the City of Tybee Island harmless on any construction
covered by this permit.
This permit must be posted in a conspicuous location in the front of building and protected from the weather. If this permit is not posted
work will be stopped. The building contractor will replace curb paving and gutter broken during construction. This permit will be voided
unless work has begun within six months of the date of issuance.
Signature of Building Inspector or Authorized Agent:
P. 0. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328
(912) 786 -4573 - FAX (912) 786 -9539
www.cityoftybee.org
CITY OF TYBEE ISLAND, GEORGIA
APPLICATION FOR BUILDING PERMIT
(o- 04-2
Location: , i g 4i S4.
NAME
ADDRESS
PIN #
TELEPHONE
Owner
S4 " d CrS
Architect
or Engineer
Building
Contractor
r
G c • fs ✓ einfeACt
(Check all that apply)
❑ Repair
❑ Renovation
❑ Minor Addition
❑ Substantial Addition
❑ Other
Details of Project:
❑ Residential
❑ Single Family
❑ Duplex
❑ Multi- Family
❑ Commercial
n Footprint Changes
n Discovery
n Demolition
Estimated Cost of Construction: $ Q 0 0
Construction Type
(1) Wood Frame
(2) Wood & Masonry
(3) Brick Veneer
Proposed use:
Remarks:
(Enter appropriate number)
(4) Masonry (6) Other (please specify)
(5) Steel & Masonry
ATTACH A COPY OF THE CERTIFIED ELEVATION SURVEY OF LOT and complete the
following information based on the construction drawings and site plan:
# Units # Bedrooms # Bathrooms
Lot Area Living space (total sq. ft.)
# Off - street parking spaces
Trees located & listed on site plan
Access:
Driveway (ft.) With culvert? With swale?
Setbacks: Front Rear Sides (L) (R)
# Stories Height Vertical distance measured from the average adjacent
grade of the building to the extreme high point of the building, exclusive of chimneys, heating
units, ventilation ducts, air conditioning units, elevators, and similar appurtances.
During construction:
On -site restroom facilities will be provided through
On -site waste and debris containers will be provided by
Construction debris will be disposed by
by means of
I understand that I must comply with zoning, flood damage control, building, fire, shore
protections and wetlands ordinances, FEMA regulations and all applicable codes and regulations.
I understand that the lot must be staked out and that the stakes will be inspected to ensure that the
setback requirements are met. I understand also that a certified plot plan showing elevation must
be attached to this application and that an as -built elevation certification is due as soon as the
habitable floor level is established. Drainage: I realize that I must ensure the adequacy of
drainage of this property so that surrounding property is in no way adversely affected. I accept
responsibility for any corrective action that may be necessary to restore drainage impaired by this
permitted construction.
Date: Signature of Applicant:
Note: A permit normally takes 7 to 10 days to process.
The following is to be completed by City personnel:
Zoning certification
Approved rezoning /variance?
Street address and number: New
Is it in compliance with City map?
If not, has street name and /or number been reported to MPC?
FEMA Certification attached
State Energy Code Affidavit attached
Utilities and Public Works:
Describe any unusual finding(s)
NFIP Flood Zone
Existing
Access to building site
Distance to water main tap site
Distance to sewer stub site
Water meter size
Storm drainage
Approvals: Signature Date
Zoning Administrator
Code Enforcement Officer
Water /Sewer
Storm /Drainage
Inspections
City Manager
FEES
Permit
Inspections
Water Tap
Sewer Stub
Aid to Const.
TOTAL
Permit Acknowledgement of
Asbestos /Environmental Notification to Georgia EPD for
Projects Involving Demolition, Wrecking, or Renovation
The undersigned hereby acknowledges that the issuance of this permit does not in any way grant
permission to the owner, owner's representative, or permit holder to proceed with demolition,
wrecking, or renovation of a structure prior to the filing of any required ten (10) day "Project
Notification for Asbestos Renovation Encapsulation or Demolition" form in accordance with
the Georgia Asbestos Rules. The Georgia Environmental Protection Division administers the
rules. In most cases, the rules require both the owner and the involved contractors to assure the
portion of the building involved in the project is thoroughly inspected by an Accredited Asbestos
Inspector for materials that contain asbestos; and the removal of the asbestos before renovation,
wrecking, or demolition begins almost without exemption. Georgia EPD requires a completed
demolition notification from be submitted 10 workings days in advance even if no asbestos is
present in the building. Further guidance for regulatory compliance and contact telephone
numbers are provided by the brochures entitled Asbestos & Renovation and Asbestos and
Demolition. Other environmental issues such as asbestos removal techniques, lead abatement,
ground contamination, or unusual site conditions may have EPD regulations that could affect the
proj ect.
Undersigned
Printed Name
Date
Office Use Only:
Project Address:
Permit Number: