Loading...
HomeMy Public PortalAboutOLD HWY 80_921 1OF2.pdfCITY OF TYBEE ISLAND BUILDING PERMIT NO WORK IN 25 -FOOT MARSH BUFFER ALLOWED DATE ISSUED: 06 -14 -2013 PERMIT #: 130388 WORK DESCRIPTION 6X16 ADD /STAIRS /CON PL EL HVAC WORK LOCATION 921 OLD HWY 80 OWNER NAME WILLIAM RUSHER ADDRESS 921 HWY 80 CITY, ST, ZIP TYBEE ISLAND GA 31328 PHONE NUMBER CONTRACTOR NAME CATSKILL BUILDERS, INC. ADDRESS 210 CATALINA DR. CITY STATE ZIP TYBEE ISLAND GA 31328 FLOOD ZONE BUILDING VALUATION SQUARE FOOTAGE 96 OCCUPANCY TYPE P TOTAL FEES CHARGED $ 213.00 PROPERTY IDENTIFICATION # PIN #4- 0026 -08 -006 PROJECT VALUATION $15,015.00 TOTAL BALANCE DUE: $ 213.00 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: =Q P. 0. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328 (912) 786 -4573 - FAX (912) 786 -9539 www.cityoftybee.org /3- PropertyAddress: d1 1 O ot to S City of Tybee Island, Georgia 912 - 472 -5033 or 912 - 472 -5031 - Fax 912 - 786 -9539 APPLICATION FOR BUILDING PERMIT j- Single Family ❑ Duplex ❑ Multi - Family ❑ Commercial Details of Project: glut -t Ylet.) 6X1lo akt '1 units rtie ►.! (Check all that apply) Die earo la Footprint C anges — new% square feet e._••-d ❑ Demolition of Structure ❑ Other CtC lZccr p� 51-t-u C4 oc...-i-`I,.,-fo ` n 'ne,•.(t J 2e c�.ee`& \e Gds, -u't a' N ` Le w rv.e c i- -!- ft -e co. c4- r t,.^1d v`� 4- erovr% k r■CW (vr li- jf Estimated Cost of Construction: '� • + (materials + labor + o overhead) 4, %tis 4—kart 10 0 O a5/-1.1 x,(4.. L ,3 S4.- 41-4-. per...-1# k 4-0 If applicable, attach a copy of the certified elevation certificate and /or survey of the property. Depending upqn the scope of the work, two sets of construction drawings and /or a site plan may be required. rt &•r'a.l vat "L• 'l — deck/s -o s w►�:•�:e.c; Year Built: Listed on National Historic Register or located within a National Historic District? Y / N * Buildings older than 50 years may be eligible to be listed on the State / National Register. With this designation, you may be eligible to take advantage of various tax incentive programs while preserving the heritage of Tybee Island. *Also see the Tybee Island Land Development Code Article 14: Historic Preservation During construction: _ On -site restroom facilities will be provided through I'a-•yS 1'-t . Construction debris will be disposed by C,c�Cn.t l by means of 11.4pp ct,,,— . I understand that I must comply with zoning, flood damage control, building, fire, shore protection and Iketland ordinances, FEMA regulations and all applicable codes and regulations. I realize that I must ensure the adequacy of drainage of this property so that surrounding property is in no way adversely affected as required by Article 16, Stormwater Management. I accept responsibility for any corrective action that may be necessary to restore drainage impaired by this permitted construction. Date: G r t� - l3 Signature of Applicant: Printed Name Note: A permit normally takes 7 to 10 days to process Approvals: Planning & Zoning Manager Building Official Water /Sewer Storm /Drainage City Manager 0 No work- tel �i- m a k buc-Ce,r alto c.ied,\` Date ‹ir• REMO FEES Permit 62e Inspections Cap Cost Rec Tap - !v-?.et Sewer Stub Eng. Fees Aid to Const.96 I/1 TOTAL Ciaj i J) �afl a-n. /3-0/66 $,2/3,00 Name Mailing Address Telephone Owner RR-- t�'° t�Sh� Home: Cell: 9( 4,0 ---183(f Architect or Engineer 6-026.etk t,,)..l- kw-G- w,, .2;1.,A Contractor CG8 -Sk=,» ato CATA /04- Office: ql3 '181 6 t'1 Cell: ata-. 'a ko tot-7 j- Single Family ❑ Duplex ❑ Multi - Family ❑ Commercial Details of Project: glut -t Ylet.) 6X1lo akt '1 units rtie ►.! (Check all that apply) Die earo la Footprint C anges — new% square feet e._••-d ❑ Demolition of Structure ❑ Other CtC lZccr p� 51-t-u C4 oc...-i-`I,.,-fo ` n 'ne,•.(t J 2e c�.ee`& \e Gds, -u't a' N ` Le w rv.e c i- -!- ft -e co. c4- r t,.^1d v`� 4- erovr% k r■CW (vr li- jf Estimated Cost of Construction: '� • + (materials + labor + o overhead) 4, %tis 4—kart 10 0 O a5/-1.1 x,(4.. L ,3 S4.- 41-4-. per...-1# k 4-0 If applicable, attach a copy of the certified elevation certificate and /or survey of the property. Depending upqn the scope of the work, two sets of construction drawings and /or a site plan may be required. rt &•r'a.l vat "L• 'l — deck/s -o s w►�:•�:e.c; Year Built: Listed on National Historic Register or located within a National Historic District? Y / N * Buildings older than 50 years may be eligible to be listed on the State / National Register. With this designation, you may be eligible to take advantage of various tax incentive programs while preserving the heritage of Tybee Island. *Also see the Tybee Island Land Development Code Article 14: Historic Preservation During construction: _ On -site restroom facilities will be provided through I'a-•yS 1'-t . Construction debris will be disposed by C,c�Cn.t l by means of 11.4pp ct,,,— . I understand that I must comply with zoning, flood damage control, building, fire, shore protection and Iketland ordinances, FEMA regulations and all applicable codes and regulations. I realize that I must ensure the adequacy of drainage of this property so that surrounding property is in no way adversely affected as required by Article 16, Stormwater Management. I accept responsibility for any corrective action that may be necessary to restore drainage impaired by this permitted construction. Date: G r t� - l3 Signature of Applicant: Printed Name Note: A permit normally takes 7 to 10 days to process Approvals: Planning & Zoning Manager Building Official Water /Sewer Storm /Drainage City Manager 0 No work- tel �i- m a k buc-Ce,r alto c.ied,\` Date ‹ir• REMO FEES Permit 62e Inspections Cap Cost Rec Tap - !v-?.et Sewer Stub Eng. Fees Aid to Const.96 I/1 TOTAL Ciaj i J) �afl a-n. /3-0/66 $,2/3,00 LEAD -BASED PAINT RRP RULES Ordinary renovation and maintenance activities can create dust that contains lead. 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. After April 22, 2010, federal law will require you to be certified and to use lead -safe work practices. Georgia Environmental Protection Division Lead -Based Paint and Asbestos Program (404) 363 -7026. Projects must be done by a Certified Lead Renovation Firm AND a Certified Renovator When disturbing lead -based painted or coated surfaces or components more than 6 ft2 per interior room or 20 ft2 of exterior surfaces AND all window replacements and partial demolitions of any size. * * * * * * * * * * * * * * * * * * * * * 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 project. * * * * * * * * * * * * * * * * * * * ** BMPs While BMP deficiencies are not necessarily the fault of the owner or his agent, BMPs are their responsibility. Two areas of deficiencies are in the most basic and common BMPs; Co — Construction Exit and Sd1 — Sediment Barrier. Correct installation information can be found in the Field Manual for Erosion and Sediment Control in Georgia, Fourth Edition 2002, Georgia Soil and Water Conservation Commission; http://www.gaswcc.org/docs/field_manual_4ed.pdf. Problems with the Co is not limited to the installation, but to material. The stone will be a representation of 1.5 " -3.5" stone or larger. Type A sediment barriers have been installed where Type C is required and shown on the permit drawings. 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. 61( (Or +� Signature for receip of read\Paint, Asbestos, and BMP notices. Date 5AvoevKi_ Printed Name CITY OF TYBEE ISLAND CERTIFICATE OF OCCUPANCY DATE COMPLETED: 10/14/2013 This Certificate issued pursuant to the requirements of the Standard Building Code Certifying that at the time of issuance this structure was in compliance with the various ordinances of the Jurisdiction regulating building construction or use. PERMIT #: 130388 PROPOSED USE: RELOCATE & RENOVATE SINGLE - FAMILY OCCUPANCY TYPE: P CONTACT NAME WILLIAM RUSHER CONTACT ADDRESS 4796 LAMBS RD CONTACT CITY STATE ZIP NORTH CHARLESTON SC 29418 -3521 PROPERTY ADDRESS 921 HWY 80 APPROVED BY: ii,„,./. 1C1): P. O. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328 (912) 786 -4573 - FAX (912) 786 -5737 www.cityoftybee.org CERTIFICATE OF OCCUPANCY REQUIREMENTS Permit # 2- D 3 O O Job Address 2 1 O 1 q (,O .? 0 Job Name S 9.5' , l. a'C--SA' l , (l j (.� (d e (—S \A Energy Code Compliance Certificate Elevation Certificate, Finished Construction C7-7_ (o As -built Survey °2(0 V Drainage Certification from Project Engineer cg12-° Recorded Non - conversion Agreement 1 04 0 IV P Breakaway Wall Certificate (V -Zone only) Mitigation of Trees 13— O02_ " ‘a 'M '3 On Drainage Certification from Downer Davis gl Z 7 Drainage Certification from Joe Wilson FEMA Inspection q/30 g g7 So erAg BiJ Rusher 184 523966 p.2 C t „ k: ; I :=42571 F FLED FOR RcCORD NONCONVERSION AGREE!! EJ 1 03:20prt; FOR STRUCTURES IN THE FLOritiPtAIN Daniel 1.4. Massey, Clerk Surerior Court of Chatham County Address of Propettto.r_ha ; .0. 14 • H41 ;: S o Building Permit Number 13 — 03 SS PIN _ 00 �6 CrirS bK7� FIRM Zone A. G BFE j feet (NAVD) Panel Number b091 31 , effective date 4 . b .- Property Owner(s) gclk. a- S . -ec�• Contractor Ca_4,51-01 t 6,4 A, In accordance with the Flood Damage Prevention Ordinance of the City of Tybee Island, Georgia, the Property Owner agrees to the following: 1. That the enclosed area below the Base Flood Elevation shall be used solely for parking of vehicles, limited storage, or access to -the building, and will never be used for human habitation without first becoming fully compliant with the Flood Damage Prevention F."> Ordinance in effect at the time of conversion. 2. That all interior walls, ceilings, and floors below the Base Flood Elevation shall be unfinished or constructed of flood- resistant materials. 3. That mechanical, electrical, or plumbing devices shall not be installed below the Base Flood Elevation. 4. That the walls of the enclosed area below the Base Flood Elevation shall be equipped with at least two vents which permit the automatic entry and exit of floodwater with total openings of at least one square inch for every square foot of enclosed area below flood level. The vents shall be on at least two different walls, and the bottoms of the vents shall be no more than one foot above grade. If located in a V -zone, breakaway walls are required. 5. That the requested structure may be subject to increased premium rates for flood insurance available from the National Flood Insurance Program due to its location in a Special Flood Hazard Area. 6. That any variation in construction beyond what is permitted shall constitute a violation and be abatable as such. Signature of Property Owner Date wner t., di,- I i 4 ✓y Printed Name p Signature of Property Printed Name of Property Owner STATE OF GEORGIA COUNTY OF CHATHAM I hereby certify that on this ! day of : �, 20 t 3 , before me, a Notary Public of the State of Georgia, personally appeared W : it ' a.rr�, v 5 t J r . , known to me, or satisfactorily proven to be the person whose name is subscribed to the foregoing instrument, who acknowledged that he /she has executed it for the purposes therein set forth, and that it is his act and deed. In w' ess whereof, I have set my hand and Notarial Seal, NOTARY .16/0Ar...t.) .S e Date %7/ 26/3 My Commission expires on WITNESS SIGNATURE Printed Name 54/1-)Z DIANNE OTTO Notary Public, Chatham County, GA My Commission Expires November 6, 20 Address (Seal) (Vote: A Nonconversion Agreement must be used whenever an enclosed structure or portion of a structure is built or substantially improved within the 100 year Floodplain below the Base Flood Elevation. A Nonconversion Agreement must satisf , all of the above conditions and requires proper recordation in the land records of Chatham County, Georgia. CITY OF TYBEE ISLAND BUILDING PERMIT ENGINEERING FEES DATE ISSUED: 06 -14 -2013 PERMIT #: 130388 WORK DESCRIPTION 6X16 ADD /STAIRS /CON PL EL HVAC WORK LOCATION 921 OLD HWY 80 OWNER NAME WILLIAM RUSHER ADDRESS 921 HWY 80 CITY, ST, ZIP TYBEE ISLAND GA 31328 PHONE NUMBER CONTRACTOR NAME CATSKILL BUILDERS, INC. ADDRESS 210 CATALINA DR. CITY STATE ZIP TYBEE ISLAND GA 31328 FLOOD ZONE BUILDING VALUATION SQUARE FOOTAGE 96 OCCUPANCY TYPE P TOTAL FEES CHARGED $ 380.50 PROPERTY IDENTIFICATION # PROJECT VALUATION $18,700.00 TOTAL BALANCE DUE: $ 87.50 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: Ard-- 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 403 Butler Ave PO Box 2749 Tybee Island, GA 31328 -2749 Ph (912) 786 -4573 FAX (912) 786 -5832 Vendor # : Issued to: 01- 002055 DAVIS ENGINEERING, INC P 0 BOX 1 6 6 3 TYBEE ISLAND, GA 31328 F.O.B. Point - Tybee Island, GA PUkCHASE ORDER PO Number: 14_23981 This number must appear on a re ated correspondence, shipping papers and invoices. Date: 08 / 2 7 / 2 0 1 3Requisition #: Ship to: CITY HALL 9 0 3 B U T L E R A V E N U E T Y B E E ISLAND, G A 3 1 3 2 8 14 -23981 Terms - Net 30 days UNE UNITS DESCRIP11ON PRICE AMOUNT 1 0.00 Eng - 921 Old Hwy 80 100- 7220 -52 -1203 Davis Engineering, Inc. invoice 421203602 dated 08/27/2013 - engineering for Rusher at 921 Old Hwy 80 Purchase Order void after 90 days. Special Instructions: 0.00 87 .50 I agree to provide the items /services listed on this purchase order and accept the Purchase Order Terms and Conditions that accompany this form. Supplier Acknowledgement Date TOTAL 87. 50 Authorized by Date For the City of Tybee Island DAVIS ENGINEERING, INC. P.O. Box 1663 Tybee Island, GA 31328 Tel. (912) 695 -7262 dkdbus(a gmail.com INVOICE August 27, 2013 Diane Otto City of Tybee Island P.O. Box 2749 Phone (912) 786 -4573 Fax: (912) 786 -9539 RE: 921 Old U.S. Highway 80 08 -27 -13 0.50 hours Final site visit 0.50 hours @ $175 = $87.50 'P,? 13 —o3Fs� �o ii)-0 3 987 Invoice #21203602 Tybee Island, GA 31328 b.1( IczAt.e. 0;a/vvv-eCD2 Dianne Otto From: Dianne Otto Sent: Tuesday, August 27, 2013 3:20 PM To: 'Downer Davis' Subject: FW: FW: bill rusher compliance letter Attachments: 21203602.doc I'm not aware of any prior or current requirement for a driveway border. Thanks, Downer. Dianne K. Otto, CFM City of Tybee Island Planning & Zoning Manager phone 912.472.5031 fax 912.786.9539 From: Downer Davis [mailto:dkdbus@gmail.com] Sent: Tuesday, August 27, 2013 2:43 PM To: Dianne Otto Subject: Re: FW: bill rusher compliance letter As Mark stated, the site has not been permanently stabilized. Therefore, I recommend that the rear sediment barrier remain until the City agrees that permanent stabilization has been provided. Also, I will advise that I did not flow test what appeared to be an open graded stone drive. I will advise that I would be very surprised, if this driveway did not meet the current and the previous flow requirements. As there was not a border to confine the stone, please advise if the City's current policy does not require borders as before. Downer On Mon, Aug 26, 2013 at 11:49 AM, Dianne Otto <Dotto@cityoftybee.org> wrote: Downer — Attached is a drainage certification letter from Mark Boswell for 921 Old Highway 80 / Bill Rusher / Catskill Builders. Please let me know if the site is acceptable and provide an invoice if it is. Thanks. Dianne K. Otto, CFM City of Tybee Island Planning & Zoning Manager phone 912.472.5031 fax 912.786.9539 From: Mark Boswell [mailto:lahbos@abellsouth.net] Sent: Monday, August 26, 2013 11:45 AM 1 BOSWELL DESIGN SERVICES, INC. 103 NASSAU DRIVE SAVANNAH, GEORGIA 31410 912 - 897 --6932 LAHBOS@BELLSOUTH.NET August 26, 2013 Diane Otto Planning and Zoning Department Tybee Island, Georgia Re: Bill Rusher Project 921 Old U.S. Highway 80 Tybee Island, Georgia Dianne, qtT. RELV,Ep At the request of the Owner, we have inspected the project referenced above for compliance with the approved drainage plan. After a brief inspection of the project, it is our opinion that the project is in substantial compliance with the approved drainage plan with the following exceptions : 1. The western swale is not well defined but would appear to function to keep storm water from migrating onto the adjacent property. 2. The drive was installed as a single drive and enters the structure to the east instead of a double drive straight in to the project. 3. It would appear that temporary stabilization is actively growing and the site is mulched. Thank you for your assistance and please do not hesitate to contact us if you should require more information. We may be reached at 897 -6932, fax to 897 -2287 or e -mail to lahbos@bellsouth.net. Sincerely, Mark Boswell q-2(0— 1 3 2 v O e,c- car City of Tybee Island • Community Development Dept. Inspection Report 403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 Phone 912.472 -5032 • Fax 912.786.9539 Permit No. ' 3 - 0 3 (eg v-her ?r d Gen. Contractor rte, .,4Sk.11 131Ctrc- . Subcontractor Owner's Name :ilk i11111ilk IITERNATIONAL CODE COUNCIL MEMBER Date Requested Date Needed Contact Information An 0 Project Address q 2 1 01 A. Scope of Work Inspector Inspection 0 t[e_..I re T.) . 04+o FetAPT k - J s_e_ 1's psle/. joy C r& 4 As- rvt% i044; 6.e., eiic-15-fe,- (re o'l-k\-6- e(J. LA in ;s e va c OJOV' Date of Inspection Pass - '( -! -3 4 a �ft rCS) Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ p-erldifj rt c e, pf- ,Df r'ec of (lea do ra,'na cer ,c or) Inspection Pass ❑ Fail ❑ Fee Fail ❑ Fee r CZVer-S,, n Ay ea...111 /17 h 0 ;4-(1 (fr d 'I`A ..1 .( i-i. 1 i !-` !Mace , re r} U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY National FloodlnsuranceProgram Important: Read the instructions on pages 1 -d. SECTION A - PROPERTY INFORMATION OMB No. 1660 -0008 Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE Al Building Owner's Name Bill Rusher Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. 921 Old Hwy 80 Company NAIC Number: City Tybee Island State GA ZIP Code 31328 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 2, Brewer's Llanding A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Residential A5. Latitude /Longitude: Lat. N 32 deq 01.1600 min Long. W 80 deq 51.1040 min Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 5 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) n/a sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade n/a c) Total net area of flood openings in A8.b n/a sq in d) Engineered flood openings? ❑ Yes ® No A9. For a building with an attached garage: a) Square footage of attached garage n/a sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade n/a c) Total net area of flood openings in A9.b n/a sq in d) Engineered flood openings? ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number Tybee Island 135164 B2. County Name Chatham B3. State GA B4. Map /Panel Number 13051 CO213F B5. Suffix F B6. FIRM Index Date 9/26/08 B7. FIRM Panel Effective /Revised Date 9/26/08 B8. Flood Zone(s) AE B9. Base Flood Elevation(s) (Zone AO, use base flood depth) 11 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other /Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other /Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date: ❑ CBRS ❑ OPA ❑ Yes ® No SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones Al A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a -h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: Vertical Datum: Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 EI NAVD 1988 ❑ Other /Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 17.3 ® feet b) Top of the next higher floor n /a. ® feet c) Bottom of the lowest horizontal structural member (V Zones only) n /a. ® feet d) Attached garage (top of slab) n /a. ® feet e) Lowest elevation of machinery or equipment servicing the building 13.0 ® feet (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 6.8 g) Highest adjacent (finished) grade next to building (HAG) 7.5 h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 6.8 ® feet ® feet ® feet ❑ meters ❑ meters ❑ meters ❑ meters ❑ meters ❑ meters ❑ meters ❑ meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. / certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ❑ Check here if attachments. licensed land surveyor? ® Yes ❑ No Certifiers Name J. Whitley Reynolds License Number 2249 FEMA For 086 -0 -33 ( 12) Date 8/22/13 Telephone 912- 352 -0464 See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the cr...esponding information from Section A. Building Street Address (including Apt, Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. 921 Old Hwy 80 FOR INSURANCE COMPANY USE Policy Number: City Tybee Island State GA ZIP Code 31328 Company NAIC Number: SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments C2.e) = N .ad Sign re Date 8/22/13 SECT,‘- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Z. es AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B, and . For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and /or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and /or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. El. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA- issued or community- issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 -G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. G3. ❑ The following information (Items G4 -G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: G9. BFE or (in Zone AO) depth of flooding at the building site: G10. Community's design flood elevation: ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Check here if attachments. FEMA Form 086 -0 -33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. 921 Old Hwy 80 Policy Number: City Tybee Island State GA ZIP Code 31328 Company NAIC Number: If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front Vied' and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. FEMA Form 086 -0 -33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 Building Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. 921 Old Hwy 80 Policy Number: City Tybee Island State GA ZIP Code 31328 Company NAIC Number. If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View "; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. FEMA Form 086 -0 -33 (7/12) Replaces all previous editions. 1 :Mil' INTERNATIONAL CODE COUNCIL MEMBER City of Tybee Island Community Development Dept. Inspection Report 403 Butler Ave. P.O. Box 2749 • Tybee Island, GA 31328 Phone 912.472 -5032 • Fax 912.786.9539 Permit No. Date Requested Owner's Name Date Needed Gen. Contractor Subcontractor Contact Information Project Address Scope of Work Inspector Date of Inspection g /mo4//3 Inspection Pass El Fail El Fee Inspection Pass Fail ❑ Fee Inspection Pass Fail El Fee Inspection Pass ❑ Fail ❑ Fee City of Tybee Island • Community Development Dept. Inspection Report 403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 Phone 912.472 -5032 • Fax 912.786.9539 Permit No. 1.5- f% f0 Owner's Name 1'f.Sf /ef ,9. Date Needed 9Il /L /f `j Gen. Contractor (11 7.ShitI L Subcontractor Contact Information kiita'f-i vi\i/ /U Project Address 6L2 / O( f) /' W J rU Scope of Work A/9/4//dOf l Inspector Date Requested d ("1.31/5 immalk INTERNATITIAL CODE COUNCIL MEMBER Date of Inspection r/ Inspection e'" J Pass El T I 131)7 61=4: 7-jr_flez 17-terri>4e 41, Tzua t- -.6Mn s J ; geT 00 )ouW, -L 6- Inspection J4C, . Pass Fail 1 Fee Inspection Fail ❑ Fee Pass 0 Fail Fee 1\S(..) 2A.-",44,4)( -±-;) l 4T - {1-4 is ,31t, Cf.i) Ac.: I f_:;,z‘oe-tin Z:OZZP4.-41e:), 6-5 Piz-L/1E7. t17-434- Inspection Pass ❑ Fail ❑ Fee EE � c City of Tybee Island • Community Development Dept. Inspection Report 403 Butler Ave. • P.O. Box 2749 Tybee Island, GA 31328 Phone 912.472 -5032 Fax 912.786.9539 Ra▪ lik INT▪ ERNATIONAL CODE COUNCIL MEMBER Permit No. /3 - v,3 ,542 Date Requested OIh3 //3 Owner's Name 4 a5 /-1 f ;e Date Needed eigJ /4-1 !/ 3 Gen. Contractor e.,ti-rseiLl. Subcontractor Contact Information /JN' -r"F1 av V , 10 -) 6 j % Project Address 9∎ / 401- i) Ad / 10 Scope of Work icSf,411 0Of L Inspector Date of Inspection J. k }u55f LL Inspection / Pass Fail 1=1 Fee 1 l' ,z Inspection S/ Pass Fail El Fee Inspection Pass ❑ Fail ❑ Fee Inspection - t Pass ❑ Fail ❑ Fee City of Tybee Island • Community Development Dept. Inspection Report 403 Butler Ave. P.O. Box 2749 • Tybee Island, GA 31328 Phone 912.472 -5032 • Fax 912.786.9539 ■I`& manna CODE COUNCIL MEMBER Permit No. Date Requested Date Needed Subcontractor Owner's Name Gen. Contractor Contact Information Project Address Scope of Work Inspector Date of Inspection Inspection Pass El Fail Fee Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee City of Tybee Island • Community Development Dept. Inspection Report 403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 Phone 912.472 -5032 • Fax 912.786.9539 Permit No. / 3- 0.3Ic' Date Requested •2'7414//3 Owner's Name A9L(. 5 /-/,(2.. Needed 0 7b6/ /3 Gen. Contractor C.f rSk'/ L �. Subcontractor Contact Information Jqe /{ g /L/ - /671 Project Address 'gal/ vG>P Aiy to Scope of Work 4/27..t, 6 G Inspector 1 .rte --� Inspection Z G(/Y//.� /NC› !----t. ��esr -i ic.: -. Pass 0 Fail El Fee C -: e-- ° Pi M Z-r•+ z)G ± n'-'41--S cif-. (, Is.11., s G-J -''›"s ue. i . arcs. INTERNATITI L CODE COUNCIL MEMBER Date of Inspection C -� I Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee DATE ISSUED: 06 -14 -2013 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 REINSPECTION FEE 6X16 ADD /STAIRS /CON PL EL HVAC 921 OLD HWY 80 WILLIAM RUSHER 921 HWY 80 TYBEE ISLAND GA 31328 CATSKILL BUILDERS, INC. 210 CATALINA DR. TYBEE ISLAND GA 31328 96 P $ 293.00 $18,700.00 PERMIT #: 130388 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 lTERPJ 'J JAL CODE COUNCIL MEMBER City of Tybee Island • Community Development Dept. Inspection Report 403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 Phone 912.472 -5032 • Fax 912.786.9539 Permit No. Date Requested Date Needed Subcontractor Owner's Name Gen. Contractor Contact Information Project Address Scope of Work Inspector Date of Inspection Inspection r " Pass Fail El Fee PIL Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee rm% OJT[ N,,,: Dui CODE COUNCIL MEMBER City of Tybee Island • Community Development Dept. Inspection Report 403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 Phone 912.472 -5032 • Fax 912.786.9539 Permit No. Date Requested Owner's Name Date Needed Gen. Contractor Subcontractor Contact Information Project Address Scope of Work Inspector Date of Inspection Inspection Pass ❑ Fail 1:1 Fee � t � 666■' > , Inspection , Pass ❑ Fail ❑ Fee ter•° Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee lea& 'I ERNA CODE COUNCIL MEMBER City of Tybee Island • Community Development Dept. Inspection Report 403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 Phone 912.472 -5032 • Fax 912.786.9539 Permit No. /3 " 1 3-9! Date Requested Owner's Name / G(.5Pe0 Date Needed Gen. Contractor et/7-6Kit 1. Subcontractor Contact Information Project Address Scope of Work Inspector 1 ! Inspection `V ! qe,21 a/y fo f 7) D i f` ©Al 1 Date of Inspection ,-T 1 , '— Pass J F Fee Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee City of Tybee Island • Community Development Dept. Inspection Report 403 Butler Ave. • P.O. Box 2749 Tybee Island, GA 31328 Phone 912.472 -5032 • Fax 912.786.9539 manna ITER t :14 CODE COUNCIL MEMBER Permit No. Date Requested Date Needed Subcontractor Owner's Name Gen. Contractor Contact Information Project Address Scope of Work Inspector Date of Inspection Inspection % .__ El ( Pass Fail Fee ii f -7 j ..----"/ ,L ca^-ti / /J - )//--1- .:///1201// /7Z / ) tbilq \11 \) ///9/1 i ;.. .L\s- I Inspection Pass ❑ Fail ❑ Fee -7 Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee IN Result Report P 07/16/2013 11:25 Serial No. CM35228060004 TC: 411866 Destination Start Time Time Prints Result Note 18888514411 07 -16 11:24 00:00:52 001/001 OK Note TMR: Timer TX, POL: Polling ORG: Original Size Setting FME: Frame Erase TX, MIX: Mixed Original TX, CALL: Manual TX, CSRC: CSRC, FWD: Forward, PC: PC -Fax, BND: Double-Sided Binding Direction, SP: Special original, FCODE: F -code, RTX: Re -TX, RLY: Relay MBX: Confidential, BUL: Bulletin, SIP: SIP Fax, IPADR: IP Address Fax, I -FAX: Internet Fax Result OK: Communication OK, S -OK: Stop Communication, PW -OFF: Power Switch OFF, TEL: RH from TEL, NG: Other Error, Cont: Continue, No Ans: No Answer, Refuse: Receipt Refused, Busy: Busy, M- Full:Memory Full, LOVR:Receiving length Over, POUER:Receiving page Over, FIL:File Error, DC:Decode Error, MDN:MDN Response Error, DSN:DSN Response Error. Tybee Island, GA GEORGIA POWER RELEASE FOR ELECTRIC SERVICE PHONE: 1- 888 - 748 -6843, Press 1, Extension 32855 or 32856 FAX: 1- 888 - 851 -4411 Location Address: Release Date: Type of Release: Temporary ,/ Permanent Permit # Electrician: Builder: Owner: Phone # •at- .--).0-7 Phone # p,J -ZAP ('"j Phone # Location Address: Release Date: Type of Release: Temporary Permanent Permit # Electrician: Phone # Builder: Phone # Owner: Phone # Planning and Zoning Jerris Bryant 912- 472 -5033 Tybee Island, GA GEORGIA POWER RELEASE FOR ELECTRIC SERVICE PHONE: 1- 888 - 748 -6843, Press 1, Extension 32855 or 32856 FAX: 1- 888 - 851 -4411 Location Address: Z 9 O Lb 1 l BC7 Type of Release: Release Date: -7//tV/3 Temporary Permanent Permit # /3 —Q3ot Phone # sl,t400 4307 Phone # •o0,1 -2.A0-10/c? Electrician: 72> S�6� Builder: C IZI () Owner: (222,+ 2 Phone # Location Address: Release Date: Type of Release: Temporary Permanent Permit # Electrician: Phone # Builder: Phone # Owner: Phone # Planning and Zoning Jerris Bryant 912 - 472 -5033 City of Tybee Island Community Development Dept. Inspection Report 403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 Phone 912.472 -5032 • Fax 912.786.9539 Permit No. /3- 193Y? Owner's Name ,l L/5 1-lf.,E°_ Gen. Contractor (1,47-5,r/(z. Date Requested Date Needed Subcontractor 0 7////3 :As* ■ INTERNAT'al4 CODE COUNCIL MEMBER �� Contact Information ����N` ilf fsArCt /307 Project Address lei( (.76 /.> J /Y 2a Scope of Work Inspector Inspection ! iYT d we-t Pass Fail J Fee Date of Inspection Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee amok Ems% I'ITERNAT:DWL CODE COUNCIL MEMBER City of Tybee Island • Community Development Dept. Inspection Report 403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 Phone 912.472 -5032 Fax 912.786.9539 Permit No. /3 0.5 foe Date Requested v M9 /.i Owner's Name fas Date Needed d 7Jd //.3 Gen. Contractor e4/5/OCZ Subcontractor Contact Information r i -i/Vtti f 417 `" /3© Project Address 4a'l/ ai y do Scope of Work ief v0(/fi7) NVA- 9/7) 7/ Inspector Date of Inspection ..!�� zr Inspection Shia ad/ y Pass E Fail El Fee ...�.. k/! / s ,4)//1),(1j-/L)1 Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee CITY OF TYBEE ISLAND BUILDING PERMIT ADDED SCOPE AND VALUE DATE ISSUED: 07 -12 -2013 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 6X16 ADD /STAIRS /CON PL EL HVAC 921 OLD HWY 80 WILLIAM RUSHER 921 HWY 80 TYBEE ISLAND GA 31328 CATSKILL BUILDERS, INC. 210 CATALINA DR. TYBEE ISLAND GA 31328 96 P $ 243.00 PIN #4- 0026 -08 -006 $18,700.00 PERMIT #: 130388 TOTAL BALANCE DUE: $ 30.00 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