HomeMy Public PortalAbout11-0391 Coco's Sunset Grilleif
City of Tuee Island • Community Developm n t Dept.
)
Inspection Report
403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328
Phone 912.786.4573 ext. 114 • Fax 912.786.9539
mum
INTERNATIONAL
CODE COUNCIL'
MEMBER
Permit No. H 0 Date Requested ! ° J �- 1
C‘t I
Owner's Name COs f + \ Q) Date Needed
Gr'n. Contractor
7: S 4 CQ
Contact Information
Project Address
Scope of Work
Inspector %P)
Inspection
Subcontractor
TrJ(e-) \JOCOLDS
2ci -27o9)
so
r D O , r r ry •
Date of Inspection
D r)a I Pass Fail El Fee
Inspection Pass Fail p Fee
Inspection Pass Fail L_.! Fee
Inspection mass
(Fail 0 Fee
DATE ISSUED: 07 -13 -2011
WORK DESCRIPTION
WORK LOCATION
CITY OF TYBEE ISLAND
BUILDING PERMIT
ROOF REPAIR -FRAME W /METAL COVER
1 OLD HWY 80 A
OWNER NAME COCO'S SUNSET GRILLE
ADDRESS P. O. BOX 31052
CITY, ST, ZIP SAVANNAH GA 31410
PHONE NUMBER
CONTRACTOR NAME Z -BEST CONSTRUCTION
ADDRESS PO BOX 401
CITY STATE ZIP FLEMING GA 31309
FLOOD ZONE
BUILDING VALUATION
SQUARE FOOTAGE
OCCUPANCY TYPE
TOTAL FEES CHARGED
PROPERTY IDENTIFICATION #
U
$ 147.00
PROJECT VALUATION $5,000.00
PERMIT #: 110391
TOTAL BALANCE DUE: $ 147.00
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:
r
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, GEOR(3I°A
APPLICATION FOR BUILDING PERMIT
Location:
NAME
•
ADDRESS
PIN #
TELEPHONE
Owner
04 54-41itiy4
MO' ke3 I
t43--
/
Architect
or Engineer
A///1" �
t
%
/'��/
•�//`
Bu
Contractor
1
7� AE' rLLx
.4
; °2J
(Check all that apply)
® Repair ❑ Residential
❑ Renovation ❑ Single Family
❑ Minor Addition n Duplex
❑ Substantial Addition ❑ Multi- Family
❑ Other ❑ Commercial
s1 -,
De .ils ofP :'ect:
❑ Footprint Changes
❑ Discovery
❑ Demolition
Estimated Cost of Construction: $ C/
Construction Type
Wood Frame
(2) Wood & Masonry
(3) Brick Veneer
(Enter appropriate number)
(4) Masonry (6) Other (please specify)
(5) Steel & Masonry
, Proposed use:
v J Remarks:
,. -C c i ATTACH A COPY OF THE CERTIFIED ELEVATION SURVEY OF LOT and complete ? l,e
• - . . following information based on the construction drawings and site plan:
4' L # Units # Bedrooms # Bathrooms
r. L Lot Area Living space (total sq. ft.)
# Off - street parking spaces
`\1___ 0 Trees located & listed on site plan
0 --4 Access:
c Driveway (ft.) With culvert? With swale?
c 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 7 c0113. f-
On -site waste and debris containers will be provided by 2 C.otS+
Construction debris will be disposed by 'Z 'r `a'tat f by means of d f ` erjsiSt'
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: 7-, % /` Signature of Applicant:
Note: A permit normally takes 7 to 10 days to process.
Tau\ ZQr r kQ-
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?
NFIP Flood Zone
Existing
FEMA Certification attached
State Energy Code Affidavit attached
Utilities and Public Works:
Describe any unusual finding(s)
Access to building site
Distance to water main tap site
Distance to sewer stub site
Water meter size
Storm drainage
Approvals: Signature
Zoning Administrator
Code Enforcement Officer
Water /Sewer
Storm /Drainage
Inspections
City Manager
Date
FEES
Permit
Inspections
Water Tap
Sewer Stub
Aid to Const.
TOTAL
LEAD -BASED PAINT
, Adapted from http: / /www.epa.gov /lead /pubs /renovation.htm. Please use that site to access the following information.
Information for Property Owners of Rental Housing, Child- Occupied Facilities
Property owners who renovate, repair, or prepare surfaces for painting in pre -1978 rental housing or space
rented by child -care facilities must, before beginning work, provide tenants with a copy of EPA's lead hazard
information pamphlet Renovate Right: Important Lead Hazard Information for Families, Child Care Providers,
and Schools. Owners of these rental properties must document compliance with this requirement. EPA's sample
pre- renovation disclosure form may be used for this purpose.
After April 22, 2010, property owners who perform these projects in pre -1978 rental housing or space rented
by child -care facilities must be certified and follow the lead -safe work practices required by EPA's Renovation,
Repair and Remodeling rule. To become certified, property owners must submit an application for firm
certification and fee payment to EPA. The Agency has up to 90 days after receiving a complete request for
certification to approve or disapprove the application.
Property owners who perform renovation, repairs, and painting jobs in rental property should also:
• Take training to learn how to perform lead -safe work practices.
• Learn the lead laws that apply regarding certification and lead -safe work practices beginning in April 2010.
• Keep records to demonstrate that you and your workers have been trained in lead -safe work practices and that you followed lead -
safe work practices on the job. To make recordkeeping easier, you may use the sample recordkeeping checklist that EPA has
developed to help contractors comply with the renovation recordkeeping requirements that took effect April 2010.
• Read about how to comply with EPA's rule in the EPA Small Entity Compliance Guide to Renovate Right.
• Read about how to use lead -safe work practices in EPA's Steps to Lead Safe Renovation, Repair and Painting.
Information for Homeowners Working at Home
If you are a homeowner performing renovation, repair, or painting work in your own home, EPA's RRP rule does not cover your project.
However, you have the ultimate responsibility for the safety of your family or children in your care. If you are living in a pre -1978 home
and planning to do painting or repairs, please read a copy of EPA's Renovate Right: Important Lead Hazard Information for Families Child
Care Providers, and Schools lead hazard information pamphlet. You may also want to call the National Lead Information Center at 1 -800-
424 -LEAD (5323) and ask for more information on how to work safely in a home with lead -based paint.
Information for Tenants and Families of Children under Age 6 in Child Care Facilities and Schools
As a tenant or a parent or guardian of children in a child care facility or school, you should know your rights when a renovation job is
performed in your home, or in the child care facility or school that your child attends.
• Before starting a renovation in residential buildings built before 1978, the contractor or property owner is required to have tenants
sign a pre- renovation disclosure form, which indicates that the tenant received the Renovate Right lead hazard information
pamphlet.
• Beginning in December 2008, the contractor must also make renovation information available to the parents or guardians of
children under age six that attend child care facilities and schools, and to provide to owners and administrators of pre -1978 child
care facilities and schools to be renovated a copy of EPA's Renovate Right: Important Lead Hazard Information for Families, Child
Care Providers, and Schools lead hazard information pamphlet.
Information for Contractors
As a contractor, you play an important role in helping to prevent lead exposure. Ordinary renovation and maintenance activities can create
dust that contains lead. By following the lead -safe work practices, you can prevent lead hazards. Contractors who perform renovation,
repairs, and painting jobs in pre -1978 housing and child- occupied facilities must, before beginning work, provide owners, tenants, and
child -care facilities with a copy of EPA's lead hazard information pamphlet Renovate Right: Important Lead Hazard Information for Families,
Child Care Providers, and Schools. Contractors must document compliance with this requirement. EPA's pre- renovation disclosure form may
be used for this purpose. Understand that after April 22, 2010, federal law will require you to be certified and to use lead -safe work
practices. To become certified, renovation contractors must submit an application and fee payment to EPA. See: Application for firm
certification. The Agency has up to 90 days after receiving a complete request for certification to approve or disapprove the application.
Contractors who perform renovation, repairs, and painting jobs should also:
• Take training to learn how to perform lead -safe work practices.
• Find a training provider that has been accredited by EPA to provide training for renovators under EPA's Renovation, Repair,
and Painting (RRP) Program. Please note that if you previously completed an eligible renovation training course you may
take the 4 -hour refresher course instead of the 8 -hour initial course from an accredited training provider to become a
certified renovator. Click here for a list of eligible courses.
• Provide a copy of your EPA or state lead training certificate to your client.
• Tell your client what lead -safe methods you will use to perform the job.
• Learn the lead laws that apply to you regarding certification and lead -safe work practices beginning in April 2010.
• Ask your client to share the results of any previously conducted lead tests.
• Provide your client with references from at least three recent jobs involving homes built before 1978.
• Keep records to demonstrate that you and your workers have been trained in lead -safe work practices and that you followed lead -
safe work practices on the job. To make recordkeeping easier, you may use the sample recordkeeping checklist that EPA has
developed to help contractors comply with the renovation recordkeeping requirements.
• Re ab ut how to comply with EPA's rule in the EPA Small Entity Compliance Guide to Renovate Right.
• Read out 9w e lead -safe work practices in EPA's Steps to Lead Safe Renovation, Repair and Painting.
•
F YOU'RE NOT
LEAD-SAFE CERTIFIED,
ISTURBING
'JUST SIX
SQUARE FEET
COULD COST YOU
BIG TIME.
Printed Name
7- 13-1/
Date
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.
p
Printed Name
_7- /5-11
Date
Office Use Only:
Project Address:
Permit Number:
June 30, 2010
The following deficiencies have reached an unacceptable level on the projects in the City of Tybee
Island. While the deficiencies are not necessarily the fault of the Owner or his agent, they are their
responsibilities. The two areas of deficiencies are in the two most basic and common BMPs on local
projects. They are:
Co — Construction Exit
Sdl — Sediment Barrier
Correct installation information can be found not only in the "Green Book" but in the Field Manual for
Erosion and Sediment Control in Georgia, Fourth Edition 2002, 4310 Lexington Road, P.O. Box 8024,
Athens, GA 30603, telephone 706.542.3065, www.gaswcc.org, Georgia Soil and Water Conservation
Commission; http: / /www.gaswcc.org /docs/
fi el d_manual_4ed.pdf.
Problems with the Co is not limited to the installation, but to the material. Specifically, the job site
personnel are telling me the stone delivered is the 1.5 " -3.5" stone they requested. I have experienced on
my own projects suppliers not adhering to the specs they are given with the orders. While I regret this
situation, I will no longer be accepting any deviation from the State requirements. The stone will be a
representation of 1.5 " -3.5" stone or larger. Gradations that are obviously smaller will no longer be
tolerated. The smaller stone allows for a smoother surface with smaller voids, thereby reducing the
function of the construction exit.
Similarly, I am finding Type A sediment barriers installed where Type C is required and shown on the
permit drawings. I have attempted to work with the Owners through increased inspections, additional
backup BMPs, etc. This has evidently become common knowledge based on the installations I am
finding. Where two rows are called for they will be installed with a separation that allows for the first one
to fail (fall over) without impacting the second one. The complete assembly and installation must be
compliant; steel or wood posts, post spacing, Type C or A.
There has been no discharge into state waters due to previous occasional deficiencies. However, the
increased frequency has created unnecessary exposure to:
1) Sediment discharge into nearby waters of the State,
2) Increased maintenance efforts by the DPW on downstream lines.
3) Due to #2, higher cost to island taxpayers.
I will be adhering strictly to the manual on all BMPs and not just these two.
Downer Davis
City of Tybee Island Consulting Engineer
Signature of Owrier /C tractor
State Licensing Board for
Residential and General Contractors
Authorized Permit Agent Form
License verification by permitting office should be completed by visiting sos.ga.gov /plb/ V Licensed Contractor: Individual Qualifying Agent
d--
Name of licensed person 6 Y L-'C f
*Please attach a copy of Individual license or Company License (Reflects company and qualifying agent license number)
License number of individual or qualifying agent:
Name of licensed company(if applicable)
License number of company(if applicable):
Licensed Individual or Qualifying Ag nt
C� r/
1- i,,A a� : �j' 1�,�� �, <-1,/)�'' to apply for and obtain the permit(s) for the
*Please atta a copy of the authorized permit agen driver's license.
2
2co-�?`4"1 /
, hereby designate
project at:
/07i
Street address
G L� \�T��
Apartment or Suite Number
City
Zip Code
I, the undersigned, being the contractor as either an individual or a qualifying agent, do hereby affirm and
swear, under oath, that all information on this form and on accompanying
Signature of individual or qualifying agent
State of
2ar la
Subscribed and sworn to before me this 3 day of " `4
cuments are true and correct.
County of C { s
Signature of Notary Publi
DIANNE OTTO
Notary Public, Chatham County, GA 237 Coliseum Drive • Macon, Georgia 31217 • (478) 207 -2440
My Commission Expires November 6, 2014
www.sos.ga.gov
20 i!
(Seal)
State Licensing Board for
Residential and General Contractors
The Authorized Permit Agent form may be used by a licensed contractor to designate an
individual to obtain permit(s) on his /her behalf for a project(s). The contractor should submit an
Authorized Permit Agent Form for each project that he /she designates an individual to pull
permits for. The form is to be given to the permit office in the city or county in which the project
is located. Do not send a copy of this form to the Board office unless you are requested to do so.
237 Coliseum Drive • Macon, Georgia 31217 • (478) 207 -2440
www.sos.ga.gov
Location:
1 CITY OF TYBEE ISLAND, GEOR .,iA
APPLICATION FOR BUILDING PERMIT
NAME
PIN # )I
Owner
�11JL ` %�- ere-yS -14A)
(' 7Lb � I �.JL..�
~
— - -_
_ ���..,...�
Architect
or Engineer
Building
Contractor
e6l1,.f.r4' f
L5 la ^ ;laic
I'
i x /5 g
.5c`
;46- e"
q
f'2 ”2--/IN
(Check all that apply)
❑ Repair
❑ Renovation
❑ Minor Addition
❑ Substantial Addition
❑ Other
Details of Project:
❑ Residential
❑ Single Family
❑ Duplex
❑ Multi- Family
❑ Commercial
❑ Footprint Changes
❑ Discovery
❑ Demolition
z
Estimated Cost of Construction: $ 6
Construction Typ
(1) Wood Frame
(2) Wood & Masonr
(3) Brick Veneer
Proposed use:
Remarks:
ATTACH A COPY OF THE CER
following information based on the
# Units
Lot Area
# Off - street parking spaces
Trees located & listed on
Access:
Driveway
Setbacks: Front
(Enter appropriate number
(4) Masonry (6) Other (please specify)
ft.)
e plan
DF LOT and complete the
# Bathrooms
_r,,, ,cuotal sq. ft.)
'v®
With culvert?
Rear
With swale?
Sides (L) (R)
# Stories Height Vertical distance measured fro 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 %4 Gc...t 7474 1-P f "4crt:, 1-11 a
On -site waste and debris containers will be provided by
Construction debris will be disposed by by means of /ee'foi4 v4
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: 2-- ' '� !/ Signature of Applicant:
Note: A permit normally takes 7 to 10 days to process.
The following is to be completed by City personnel:
Zoning certifica
Approved rezonin a variance?
Street address and nu •ber: New
Is it in compliance with ►'ty map?
If not, has street name and . number been reported; • MPC?
NF Flood Zone
Existing
FEMA Certification attached
State Energy Code Affidavit attach
Utilities and Public Works:
Describe any unusual finding(s)
Access to building site
Distance to water main .p site
Distance to sewer s site
Water meter size
Storm drainage
Approvals: Signature Date
Zoning A. inistrator
Code Enforcement Officer
Water /Sewer
Storm /Drainage
Inspections
City Manager
FEES
Permit
Inspections
Water Tap
Sewer Stub
Aid to Const.
TOTAL
LEAD -BASED PAINT
Adapted from http: / /www.epa.aov /lead /pubs /renovation.htm. Please use that site to access the following information.
Information for Property Owners of Rental Housing, Child- Occupied Facilities
Property owners who renovate, repair, or prepare surfaces for painting in pre -1978 rental housing or space
rented by child -care facilities must, before beginning work, provide tenants with a copy of EPA's lead hazard
information pamphlet Renovate Right: Important Lead Hazard Information for Families, Child Care Providers,
and Schools. Owners of these rental properties must document compliance with this requirement. EPA's sample
pre- renovation disclosure form may be used for this purpose.
After April 22, 2010, property owners who perform these projects in pre -1978 rental housing or space rented
by child -care facilities must be certified and follow the lead -safe work practices required by EPA's Renovation,
Repair and Remodeling rule. To become certified, property owners must submit an application for firm
certification and fee payment to EPA. The Agency has up to 90 days after receiving a complete request for
certification to approve or disapprove the application.
Property owners who perform renovation, repairs, and painting jobs in rental property should also:
• Take training to learn how to perform lead -safe work practices.
• Learn the lead laws that apply regarding certification and lead -safe work practices beginning in April 2010.
• Keep records to demonstrate that you and your workers have been trained in lead -safe work practices and that you followed lead -
safe work practices on the job. To make recordkeeping easier, you may use the sample recordkeeping checklist that EPA has
developed to help contractors comply with the renovation recordkeeping requirements that took effect April 2010.
• Read about how to comply with EPA's rule in the EPA Small Entitv Compliance Guide to Renovate Right.
• Read about how to use lead -safe work practices in EPA's Steps to Lead Safe Renovation, Repair and Painting.
Information for Homeowners Working at Home
If you are a homeowner performing renovation, repair, or painting work in your own home, EPA's RRP rule does not cover your project.
However, you have the ultimate responsibility for the safety of your family or children in your care. If you are living in a pre -1978 home
and planning to do painting or repairs, please read a copy of EPA's Renovate Right: Important Lead Hazard Information for Families, Child
Care Providers, and Schools lead hazard information pamphlet. You may also want to call the National Lead Information Center at 1 -800-
424 -LEAD (5323) and ask for more information on how to work safely in a home with lead -based paint.
Information for Tenants and Families of Children under Age 6 in Child Care Facilities and Schools
As a tenant or a parent or guardian of children in a child care facility or school, you should know your rights when a renovation job is
performed in your home, or in the child care facility or school that your child attends.
• Before starting a renovation in residential buildings built before 1978, the contractor or property owner is required to have tenants
sign a pre- renovation disclosure form, which indicates that the tenant received the Renovate Right lead hazard information
pamphlet.
• Beginning in December 2008, the contractor must also make renovation information available to the parents or guardians of
children under age six that attend child care facilities and schools, and to provide to owners and administrators of pre -1978 child
care facilities and schools to be renovated a copy of EPA's Renovate Right: Important Lead Hazard Information for Families, Child
Care Providers, and Schools lead hazard information pamphlet.
Information for Contractors
As a contractor, you play an important role in helping to prevent lead exposure. Ordinary renovation and maintenance activities can create
dust that contains lead. By following the lead -safe work practices, you can prevent lead hazards. Contractors who perform renovation,
repairs, and painting jobs in pre -1978 housing and child- occupied facilities must, before beginning work, provide owners, tenants, and
child -care facilities with a copy of EPA's lead hazard information pamphlet Renovate Right: Important Lead Hazard Information for Families,
Child Care Providers, and Schools. Contractors must document compliance with this requirement. EPA's pre- renovation disclosure form may
be used for this purpose. Understand that after April 22, 2010, federal law will require you to be certified and to use lead -safe work
practices. To become certified, renovation contractors must submit an application and fee payment to EPA. See: Application for firm
certification. The Agency has up to 90 days after receiving a complete request for certification to approve or disapprove the application.
Contractors who perform renovation, repairs, and painting jobs should also:
• Take training to learn how to perform lead -safe work practices.
• Find a training provider that has been accredited by EPA to provide training for renovators under EPA's Renovation, Repair,
and Painting (RRP) Program. Please note that if you previously completed an eligible renovation training course you may
take the 4 -hour refresher course instead of the 8 -hour initial course from an accredited training provider to become a
certified renovator. Click here for a list of eligible courses.
• Provide a copy of your EPA or state lead training certificate to your client.
• Tell your client what lead -safe methods you will use to perform the job.
• Learn the lead laws that apply to you regarding certification and lead -safe work practices beginning in April 2010.
• Ask your client to share the results of any previously conducted lead tests.
• Provide your client with references from at least three recent jobs involving homes built before 1978.
• Keep records to demonstrate that you and your workers have been trained in lead -safe work practices and that you followed lead -
safe work practices on the job. To make recordkeeping easier, you may use the sample recordkeeping checklist that EPA has
developed to help contractors comply with the renovation recordkeeping requirements.
• Read about how to comply with EPA's rule in the EPA Small Entity Compliance Guide to Renovate Right.
• Rea )bout how to use lead -safe work practices in EPA's Steps to Lead Safe Renovation, Repair and Painting.
IF YOU'RE NOT
LEAD•SAFECERTIFIED,
ISTURBING
'JUST SIX
SQUARE FEET
COULD COSTYOU
BIGTIMi.
g ^ /7
Signature Date
r
Printed Name
Permit Acknowledgement of
Asbestos /Environmental Notification to Georgia EPD for
Proiects 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
192 //e. 4
Printed Name
�^ 1i/
Date
Office Use Only:
Project Address:
Permit Number: