HomeMy Public PortalAbout11-0556 Applepeel Properties_1of4CITY OF TYBEE ISLAND
CERTIFICATE OF OCCUPANCY
DATE COMPLETED: 12/16/2011
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 #: 110556
PROPOSED USE: CONVERT TO PRIVATE LAUNDRY
OCCUPANCY TYPE: U
CONTACT NAME APPLEPEEL PROPERTIES LLP
CONTACT ADDRESS PO BOX 402
CONTACT CITY STATE ZIP TYBEE ISLAND GA 31328
PROPERTY ADDRESS 407 FIRST ST
APPROVED BY:
THIS BUILDING IS DR OODPROOFED.
P. O. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328
(912) 786 -4573 - FAX (912) 786 -5737
www.cityoftybee.org
City of Tee Island • Community Developn...nt Dept.
Inspection Report
403 Butler Ave. • P.O. Box 2749 Tybee Island, GA 31328
Phone 912.786.4573 ext. 114 Fax 912.786.9539
matank
INTERNATIONAL
CODE COUNCIL
MEMBER
Permit No. 1 1- 0 5$ Date Requested i 2- 09 -2.z) 1 i
Owner's Name ,Ap p\ 2 pe e ( Prcf , Date Needed
Gen. Contractor w h• 41 o u.J CO an 4. Subcontractor
Contact Information
Project Address 40'7 5-I-.
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Scope of Work 0.' )r ✓e r - 4-o r , J!� `t'eJ la J n d r `!
Inspector Date of Inspection \ ! - \ \'
Inspection 1 E CA A Pass El Fail Ei Fee
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Inspection Pass ❑ Fail 0 Fee
RECEIVED
After recording, please return to:
Applepeel Properties, LLP
PO Box 402
Tybee Island, GA 31328
STATE OF GEORGIA )
COUNTY OF CHATHAM )
241 DEC -`1 A qr 32
Notice Regarding Base Floor
Elevation and Flood - proofing Measures
Cross Reference: Warranty Deed from Scott R. Sharer and Sandra J. Sharer, as
grantor, in favor of Applepeel Properties, LLC, as grantee, recorded at Deed Book 181A,
Page 467, Records of Chatham County, Georgia
This instrument is made by Applepeel Properties, LLP, a Georgia Corporation,
(the "Declarant "). Declarant is the present owner of the land (the "Land ") described on
Exhibit "A" attached hereto and acquired pursuant to the Deed. Declarant is in the
process of constructing that building (the "Building ") which is located on the Land, is now
commonly known as 407 First Street, Tybee Island, Chatham County, Georgia, and is
shown and described as a Lot 111, Ward No. 1, Tybee Island, Chatham County, Georgia
located on that Plat, which Plat has been recorded in Plat Book 46P page 98
in the Office of the Clerk of Superior Court, Chatham County, Georgia. The Building is
shown on that site plan attached hereto as "Exhibit B ". Declarant hereby gives notice that
the Building is in an AE flood zone and has been flood - proofed one foot above the base
flood elevation to 14 MSL (NAVD) instead of raising the finish floor to the base flood
elevation, and that the owner of the Building has the responsibility to create a flood
protection standard operating procedure as outlined in Federal Insurance Administration:
Non - Residential Floodproofing - Requirements and Certification Technical Bulletin 3 -93
or revised editions which describes how a storm is to be identified, who will be
responsible for installing the flood panels, where the flood panels are, how to identify the
flood panels to the designated locations, when to remove and store the panels, yearly
inspection and "dry run ", and maintenance of the flood panels to ensure they will not
breakdown or be misplaced.
Executed by the undersigned as follows:
Signed, sealed and delivered this day of
December 2011 in the presence of:
W' ess 4
Notary Public
My Commission Expires on: ®.3)oz .),Zol
Applepeel Properties, LLP
By: Carrie Gaster Efifd
Its: Member
EXHIBIT "A"
All that certain lot, tract or parcel of land situate, lying and being in the City of Tybee
Island, Chatham County, Georgia, shown and designated on the map or plan of said City
as Lot Number One Hundred Eleven (111), Ward One(1), said lot having a frontage of
sixty (60) feet on Fourth Avenue and a rectangular depth of One Hundred Ten (110') feet,
and being bounded as follows: On the North by Lot Number One Hundred Ten (110) of
said Ward; on the East by Lot Number Ninety -six (96) of said Ward; on the South by
First Street; and on the West by Fourth Avenue.
Less and Except that certain portion of the above - described property measuring 0.098
acres, more or less, conveyed by Henry M. Buckley to the State Highway Department of
Georgia, for the widening of State Highway No. 26, in a Right -of -Way Deed dated
March 8, 1961, and recorded April 18, 1961, in the Office of the Clerk of Superior Court
of Chatham County, Georgia, in Deed Record Book 77 -Q, Folio 296.
Further Less and Except that certain portion of the above - described property subject to a
Right -of -Way Easement conveyed by Henry M. Buckley to the State Highway
Department of Georgia in an instrument dated March 18, 1961 and recorded on April 18,
1961, in the Office of the Clerk Superior Court of Chatham County, Georgia in Deed
Record Book 77 -Q, Folio 297, said easement granting the State Highway Department of
Georgia the right to construct and maintain over and upon any portion of the subject
property abutting on and adjacent to State Highway No. 26, any embankment or cuts as
said Highway Department may deem proper to support or accommodate the improvement
of said highway, including the right to construct and maintain any required drainage
structures, retaining walls, channel change, or ditches.
Subject, however, to all valid easements, restrictions, covenants, and right of way record.
BOSWELL DESIGN SERVICES, INC.
103 NASSAU DRIVE
SAVANNAH, GEORGIA 31410
912-897-6932
LAHBOS@BELLSOUTH. NET
407 First Street - Applepeel Properties, LLC - Flood Operation Plan/Standard Operating Procedures
1. PURPOSE
This document outlines the actions and responsibilities required to maintain and protect Applepeel Properties,
LLC, dba Tybee Vacation Rentals hereafter to be called TVR located at 407 First Street, from a flood. This
flood operation plan includes requirements for the Emergency Action Plan, Annual inspection and the
Maintenance and Training Plan required to retain the Certificate of Occupancy for the building.
2. EMERGENCY AC HON PLAN
The following steps are to be taken by the building owner, TVR, during a flood.
A. Chain of Command
1. Responsibility: The primary responsibility for maintaining and carrying out the flood emergency plan
shall lie with a Member of TVR.
2. Notification: The primary responsibility for notification of a flood event lies with TVR, hereby named
as the manager. The manager will monitor weather reporting agencies and be the main point of
contract with emergency management officials. In the event that the manager is unavailable the
responsibility will lie with the assistant manager.
3. Preventative Action: The primary responsibility for ensuring the preventative actions are put into place
shall lie with the manager. He /She will coordinate the installation of all of the flood deterrent measures.
In the event the primary contact is unavailable, the assistant manager, will implement the preventative
actions.
4. Maintenance Action: The primary responsibility for ensuring the maintenance action plan is
maintained shall lie with the manager. He /She will coordinate annual installation drills, review and
update contents and accuracy of the plan, review storage and general condition of the flood deterrent
measures and review the overall performance in ensuring the safety of the building, its occupants and its
content at least once per year. In the event that the Manager is unavailable, the responsibility falls upon
the assistant manager.
Procedures
1. Monitoring and initial notification: Ongoing monitoring for potential flood events will be the
responsibility of the Manager. The manager will subscribe to a weather alert service that issues
automated warnings of potential flood events on a 24/7 basis. Responsibility for maintaining and
monitoring the weather alert system will fall to the Manger. A flood will be considered as pending when
an official "watch" or "warning" is issued by the National Weather Service for any of the following:
a. Flood
b. Tropical Storm/Gale
c. Hurricane
2. Procedures: The following procedures shall be followed during a pending flood event:
a. Notification: When a potential flood event is publicly announced, the manager, will notify the
assistant manager.
b. Decision: the manager will assess the potential impact and timing of the flooding threat.
Based on a consensus of the available other responsible parties, he /she will determine if
implementation of the flood measures is necessary.
c. Implementation: If implementation is mandated, the Manager will install the flood deterrent
measures.
d. Evacuation: Simultaneously, the Manager will coordinate the evacuation of staff from the
facility.
e. Confirmation: Upon completion of the implementation of the flood deterrent measures and
the evacuation of the facility, the Manager will contact the Tybee Island Community
Development Dept.
f. Response Time: The Manager will consider the response time required to implement the
flood prevention measures in determining the implementation.
3. Restoration of Standard Activities: Once a "watch" or "warning" has been lifted by the National
Weather Service, the Manager may confirm the restoration of normal activities. The Manager will
notify the Tenant that they can return to the facility and restart operations. The Manager will also
instruct staff to remove the flood deterrent measures and return them to their proper storage.
3. ACTIVE FLOOD DETERRENT MEASURES
The following outlines the physical flood deterrent measures that require installation of or action by the Owner's
staff to put in place. These measures must be implemented in an emergency situation at the building. The flood
deterrent measures have been set in place to create flood resistance throughout the building.
1. Doors: There are three exterior doors and one roll -up door that require flood - proofing measures.
a. Aluminum Plates: There are custom fabricated aluminum plates fabricated to fit over each door
opening. Each plate is permanently marked to indicate which door they fit and which way the plate
faces (up, down, right, left). Each plate was fabricated from aluminum and weights approximately
50 pounds. Each will require one person to set into place. These plates are stored in the office
area.
b. Seals: Each pate is fitted with a neoprene seal. The seal is permanently attached to each plate.
c. Bolts: Each plate will require bolts to install. All brackets shall be left connected to building.
2. Plumbing System:
a. Domestic Water System: There is a main shut-off valve. The valve should be closed to the off
position and locked during a flood event.
3. Electrical and Mechanical systems: All exterior electrical and mechanical systems are above flood plain
elevation.
4. PASSIVE FLOOD DETERRENT MEASURES
The following outlines physical flood deterrent measures that have been permanently set in place. While these
require no action by the owner's staff during a potential flood event, they will require periodic maintenance and
inspection to ensure their ongoing stability and functionality.
1. Architectural:
a. Waterproofing: All masonry walls have been coated with a waterproofing system from below
ground level to one foot (1') above flood elevation. The waterproofing surface is concealed by the
exterior paint.
b. Doors: Please see above door system.
2. Structural:
a. Slab: N.A.
3. Plumbing Systems: All fittings in the flood- proofed rooms are equipped with water -tight collars to prevent
water infiltration and seepage. The main water line is outfitted with a backflow preventer.
4. Mechanical and Electrical Systems: see above.
5. DUTIES
Two members of the on-call maintenance staff will execute the following activities upon notification from the
Manager:
1. Door protection:
a. Go to office and locate necessary materials
b. Locate the door panels
c. Set door panels with corresponding door in proper orientation
d. Verify neoprene seals are in place
e. Install door panels
2. Water Shutdown:
a. Verify all water valves are in the off position
b. Locate the main shut-off valve on the right side (west) of building and shut off
3. Mechanical and Electrical Shutdown:
a. Turn off all Mechanical equipment
b. Set main disconnect in main power panel to OFF
6. ANNUAL INSPECTION, MAINTENANCE AND TRAINING PLAN
The manager partner or assign will require an annual inspection, maintenance and training as follows:
1. Inspection and Maintenance: The owner recognizes that there shall be an annual routine inspection that
these measures remain viable. The following is an inspection schedule for the flood deterrents. The reports
should be filled out annually with the manager and filed at their home office. Every five years, the report,
accompanied by the report of a registered structural engineer and the staff reports from the previous years,
will be filed with a summary cover letter to the Tybee Island Community Development Dept., noting the
condition and maintenance of the flood - proofing systems as outlined below.
a. Doors Protection:
i. Aluminum Plates: Annually inspect to verify that all panels are properly stored. Staff will
annually install the panels in accordance with the procedures listed above. Every five
years, a registered structural engineer should also inspect and report on the observed
condition of the door protection system.
ii.
Seals. Annually inspect all seals to ensure that seals remain resilient and watertight.
Inspections should note any cracks or defects in the gaskets.
iii. Bolts: Verify all bolts are present for all doors and properly stored.
b. Waterproofing: On an annual basis, the owner will water down the stucco portion of the CMU
wall and notice any water intrusion in to the building. Inspections should note any cracking,
damage areas or loss adhesion. Every five years, a structural engineer should also inspect and
report on the observed condition of the waterproofing.
c. Interior Finishes: Annually review the interior finishes in the building to determine if there are any
defects or failures in the integrity of the surface. Inspections should note surface cracking, loss of
adhesion and other potential failure indicators.
d. Slab and Concrete Masonry Walls: Staff should provide an annual review and report any surface
cracks, settling, depressions or heave in the concrete slab and masonry walls. Every five years a
structural engineer should also inspect and report on the observed condition of the slab and
masonry walls.
e. Plumbing Systems:
i. Domestic Water System: Annually verify that all valves are in working condition. Any
defects should be corrected immediately.
ii. Fittings: Verify annually by use of a pressure test that all fittings remain watertight to a
pressure of 40 psi. Any defects should be corrected immediately.
f. Mechanical and Electrical Systems: Annually verify disconnects and other equipment is
operational and provide safe shut down of all electrical and mechanical systems to the facility.
7. TRAINING
On an annual basis, the Manager or assign will conduct a training session for all employees assigned to
implement the flood - proofing measures. Tybee Island Community Development Dept. will be notified at least
one week in advance of the training session. The session should include the following:
a. Review of potential dangers and hazards associated with occupying a building located within a
floodplain.
b. Review of the physical flood - proofing measures required to secure the structure. Review the
components and processes required to install the active flood - proofing measures as well as an
overview of the inactive measures already put in place.
c. Review of the evacuation plan for staff associated with the facility. This should also include a review
and confirmation of the alternate relocation sites and alternate travel routes.
d. Review annual and five -year inspection and maintenance reports.
e. Response Time: On an annual basis, the Manager will document and forward for review by the
governing authorities the response times to implement the flood prevention measures. The
response times will include travel time to and from installers' homes and time to notify that the
measures have been put in place. Annual drills will be held to certify and update the response
time.
8. SURVIVORSHIP
The requirements and conditions of this document will be recorded by reference as part of the title to the
property and shall ran with the land to all future owners and tenants. Any changes or modifications to this
document require the review and consent of the Tybee Island Community Development Dept.
Field Report
To:
BOSWELL DESIGN SERVICES, INC.
103 NASSAU DRIVE
SAVANNAH, GEORGIA 31410
912-897-6932
LAHBOSOBELLSO UTH. NET
City of Tybee
403 Butler Ave.
Tybee Island, GA 31328
From: Mark Boswell
Date: December 8, 2011
Visit: duration of construction
Project: 407 First Street, Tybee Island, GA — Applepeel Properties, LLC, Tybee Island
These are field observations with the flood proofing of the above - referenced project.
A.
Slab: N.A. — slab was existing
B.
Mechanicals: All exterior mechanicals are installed above flood elevation. Water heater tank was raised.
Sewer system was installed with a back flow preventer.
C.
Concrete block wall: Waterproofing membrane was applied to the CMU wall to counteract water leakage
during a flood. The CMU walls were inspected and accepted by my office.
D.
Flood panels: The flood panels were custom fabricated for each door location and numbered. Each panel is
aluminum with neoprene gaskets, designed to resist the passage of water and withstand the lateral loads
during a flood. The panel system is anchored to each door opening wall with threaded bolts. The panels are
stored in the office area. The flood panels have been inspected by my office and are accepted.
Please see attached executed Flood Proofing Certification letter.
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 -9.
OMB No. 1660 -0008
Expires March 31, 2012
SECTION A - PROPERTY INFORMATION
For Insurance Company Use:
Al. Building Owner's Name Applepeel Properties, LLC
Policy Number
A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No.
407 First Street
Company NAIC Number
City Tybee Island State GA ZIP Code 31328
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Pt. lot 111, Ward One
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.)
A5. Latitude /Longitude: Lat. N 32 deg 00.795 min Long. W 80 deq 50.637min
A6. Attach at least 2 photographs of the building if the Certificate is being used
A7. Building Diagram Number 1
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) n/a sq ft
b) No. 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
non - residential
Horizontal Datum: ❑ NAD 1927 ® NAD 1983
to obtain flood insurance.
A9. For a building with an attached garage:
a) Square footage of attached garage n/a sq ft
b) No. 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
B5. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood
B9. Base Flood Elevation(s) (Zone
13051 CO213F
F
Date
Effective /Revised Date
Zone(s)
AO, use base flood depth)
9/26/08
9/26/08
AE
11
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
El FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe)
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other (Describe)
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?
Designation Date ❑ CBRS ❑ OPA
Cl 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 A1-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. Use the same datum as the BFE.
Benchmark Utilized localVertical Datum NAVD 1988
Conversion /Comments
Check the measurement used.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 10.3 ® 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 n /a. ® feet
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 9.7
g) Highest adjacent (finished) grade next to building (HAG) 10.1
h) Lowest adjacent grade at lowest elevation of deck or stairs, including n /a.
structural support
® feet
® feet
® feet
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
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. I certify that the information on this Certificate represents my best efforts to interpret the data available.!
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
licensed land surveyor? ® Yes ❑ No
Certifier's Name J. Whitley Reynolds License Number 2249
Title Company Name J. Whitley Reynolds, Land Surveyor
Address 636 S on ite C City Savannah, State GA ZIP Code 31405
Atur= ATMrr
Signa
FEMA Fo 81 -31, Mar 09
Date 7/12/11
Telephone 912 - 352 -0464
See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the c sponding information from Section A.
Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No.
407 First Street
For Insurance Company Use:
Policy Number
City Tybee IslandState 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
Sign- ure
Date 7/12/11
❑ Check here if attachments
SECT E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones 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 C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
El. 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.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owners 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 and G9.
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 -G9) 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: ❑ feet ❑ meters (PR) Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum
G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum
Local Official's Name
Title
Community Name
Telephone
Signature
Date
Comments
❑ Check here if attachments
FEMA Form 81 -31, Mar 09
Replaces all previous editions
Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
407 First Street
Policy Number
City Tybee Island State GA ZIP Code 31328
Company NAIL Number
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View "; and, if required, "Right
Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page,
following.
Front View Jul 11, 2011
Building Photographs
Continuation Page
For Insurance Company Use:
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
407 First Street
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."
Rear View July 11, 2011
U.S. DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY
National Flood Insurance Program
FLOODPROOFING CERTIFICATE
FOR NON- RESIDENTIAL STRUCTURES
0.M.B. NO. 1660 -0008
Expires March 31, 2012
The floodproofing of non - residential buildings may be permitted as an alternative to elevating to or above the Base Flood Elevation;
however, a floodproofing design certification is required. This form is to be used for that certification. Floodproofing of a residential building
does not alter a community's floodplain management elevation requirements or affect the insurance rating unless the community has
been issued an exception by FEMA to allow floodproofed residential basements. The permitting of a floodproofed residential basement
requires a separate certification specifying that the design complies with the local floodplain management ordinance.
BUILDING OWNER'S NAME
Q,AR.21 E.. E%` ► Ro
STREET ADDRESS (Including Apt., Unit, Suite, and /or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER
40i as-c' SC
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
FOR INSURANCE COMPANY USE
POLICY NUMBER
COMPANY NAIC NUMBER
CITY
it.6€t 15L D
STATE ZIP CODE
44. 3132i
SECTION I —FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM:
COMMUNITY NUMBER
I 3 D S 1 C
PANEL NUMBER
a2 t
SUFFIX
DATE OF FIRM INDEX
i- 2!e - 2. / . . o 8
FIRM ZONE
1 . 4 . E . - 1 1
BASE FLOOD ELEVATION
(In AO Zones, Use Depth)
I 1.00
SECTION II— FLOODPROOFING INFORMATION (By a Registered Professional Engineer or Architect)
Floodproofing Design Elevation Information:
Building is floodproofed to an elevation of (2' 0 feet NGVD. (Elevation datum used must be the same as that on the FIRM.)
Height of floodproofing on the building above the lowest adjacent grade is Z.0 feet.
(NOTE: For insurance rating purposes, the building's floodproofed design elevation must be at least one foot above the Base Flood Elevation to receive rating
credit. If the building is floodproofed only to the Base Flood Elevation, then the building's insurance rating will result in a higher premium.)
SECTION III — CERTIFICATION (By a Registered Professional Engineer or Architect)
Non - Residential Floodproofed Construction Certification:
I certify that, based upon development and /or review of structural design, specifications, and plans for construction, the design and methods of construction
are in accordance with accepted standards of practice for meeting the following provisions:
The structure, together with attendant utilities and sanitary facilities, is watertight to the floodproofed design elevation indicated above, with
walls that are substantially impermeable to the passage of water.
All structural components are capable of resisting hydrostatic and hydrodynamic flood forces, including the effects of buoyancy, and anticipated
debris impact forces.
I certify that the information on this certificate represents my best efforts to interpret the data available. I understand that any fal
by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal)
t \Al2- t3OSiCt`. Pi- D 2i' 31 2--
TITLE COMPANY NAME
E Pet N1zV..AP-
ADDRESS
►a 3 1\\AcsE-.40 ' VC.
136w 1=.s 14N
CITY STATE
U1'
1t(ak 0- •
ZIP CODE
t4fo
SIGNATURE
DATE PHONE
12. -S -11 112 -511— V152_
Copies should be made of this Certificate for: 1) community official, 2) Insurance agent /company, and 3) building owner.
FEMA Form 81 -65, Mar 09
REPLACES ALL PREVIOUS EDITIONS F -056 (3/09)
FLOOD INSURANCE
FLOODPROOFING CERTIFICATE
FEMA FORM 81 -65
GENERAL —This information is provided pursuant to Public Law 96 -511 (the Paperwork Reduction Act of 1980, as amended), dated December
11, 1980, to allow the public to participate more fully and meaningfully in the Federal paperwork review process.
AUTHORITY — Public Law 96 -511, amended; 44 U.S.C. 3507; and 5 CFR 1320
PAPERWORK BURDEN DISCLOSURE NOTICE — Public reporting burden for this data collection is estimated to average 3.25 hours per
response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and submitting this form. You are not required to respond to this collection of information unless a valid
OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for
reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency,
500 C Street SW, Washington, DC 20472, Paperwork Reduction Project (1660- 0008).
NOTE: Do not send your completed form to this address.
BOSWELL DESIGN SERVICES, INC.
103 NASSAU DRIVE
SAVANNAH, GEORGIA 3 1410
912 -897— 6932
LAHBOS @BELLSOUTH.NET RECEIVED
.12 .1i
December 8, 2011
Diane Otto
Planning and Zoning
Tybee Island, Georgia
Re: Carrie Efird Laundry
Applepeel Properties
407 First Street
Tybee Island, Georgia
Diane,
At the request of the Owner, we have inspected the project referenced above for
compliance with the approved site plan.
After a brief inspection of the project, it is our opinion that the project is in substantial
compliance with the approved site plan including final stabilization.
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
Dianne Otto
From: Joe Wilson
Sent: Tuesday, December 13, 2011 10:21 AM
To: 'Downer Davis'; Dianne Otto
Cc: Steele Knudson
Subject: RE: laundry
I concur. I'm good with it.
From: Downer Davis [mailto:dkdbus @gmail.com]
Sent: Tuesday, December 13, 2011 9:05 AM
To: Dianne Otto
Cc: Joe Wilson; Steele Knudson
Subject: Re: laundry
I overlooked the absence of this letter in my prior sign -off. With unusual projects that don't fit a normal permit
flow, that's not surprising. I'm still good with closing this out.
Downer
On Tue, Dec 13, 2011 at 8:31 AM, Dianne Otto <Dotto@cityoftybee.org> wrote:
Dear Downer and Joe,
Attached is a site acceptance letter from Mark Boswell. This was attached to the Flood Operation
Plan so I did not realize I had it until late yesterday.
Joe, with the attached email regarding the tree mitigation being completed are you able to accept
the site?
Thank you,
Dianne K. Otto, CFM
City of Tybee Island
phone 912.786.4573 ext. 136
fax 912.786.9539
1
From: Downer Davis [mailto:dkdbus@gmail.com]
Sent: Monday, December 12, 2011 3:28 PM
To: Dianne Otto
Cc: Joe Wilson
Subject: Re: laundry
The site appears to be compliant with the site work portion of the permit.
The north side has been stabilized with open graded stone rather than the pine straw mulch I remember.
However, under the current ordinances I believe this is allowed.
Downer
On Mon, Dec 12, 2011 at 10:40 AM, Dianne Otto <Dotto @cityoftybee.org> wrote:
Downer and Joe,
If there are no issues please document for the file your acceptance of the private laundry
site, 407 First Street, as soon as possible. If there are any issues let me know so I can
communicate them to the contractor. They are eager to closeout.
Thank you,
Dianne K. Otto, CFM
City of Tybee Island
phone 912.786.4573 ext. 136
fax 912.786.9539
This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the
named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by
mistake and delete this e-mail from your system. Please note that any views or opinions presented in this email are solely those of the author and do not
necessarily represent those of The City of Tybee Island. The recipient should check this email and any attachments for the presence of viruses. The City of Tybee
Island accepts no liability for any damage caused by any virus transmitted by this email. City of Tybee Island P.O. Box 2749 Tybee Island, GA 31328
............................................................................................. ...............................
2
............................................................................................. ...............................
This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the
named addressee you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by
mistake and delete this e-mail from your system. Please note that any views or opinions presented in this email are solely those of the author and do not
necessarily represent those of The City of Tybee Island. The recipient should check this email and any attachments for the presence of viruses. The City of Tybee
Island accepts no liability for any damage caused by any virus transmitted by this email. City of Tybee Island P.O. Box 2749 Tybee Island, GA 31328
Forwarded message
From: Dianne Otto <Dotto @cityoftybee.org>
To: Joe Wilson <jwilson @cityoftybee.org>
Cc: Steele Knudson <sknudson( cityoftybee.org>, Downer Davis <dkdbus @gmail.com>
Date: Mon, 12 Dec 2011 15:38:28 -0500
Subject: RE: laundry
Joe - The required mitigation was replanting 1 tree to bring the density up to the required 1
per 1,500 square feet. Per Steele, that has been completed. The file has been closed.
Dianne K. Otto, CFM
City of Tybee Island
phone 912.786.4573 ext. 136
fax 912.786.9539
From: Joe Wilson
Sent: Monday, December 12, 2011 3:17 PM
To: Dianne Otto; Downer Davis
Subject: RE: laundry
What was the mitigation for the tree removals ?
From: Dianne Otto
Sent: Monday, December 12, 2011 10:40 AM
To: Downer Davis; Joe Wilson
Subject: laundry
3
Downer and Joe,
If there are no issues please document for the file your acceptance of the private laundry
site, 407 First Street, as soon as possible. If there are any issues let me know so I can
communicate them to the contractor. They are eager to closeout.
Thank you,
Dianne K. Otto, CFM
City of Tybee Island
phone 912.786.4573 ext. 136
fax 912.786.9539
4
Dianne Otto
From: Shirley Sessions [ssessions @uwce.org]
Sent: Saturday, October 29, 2011 9:41 AM
To: Steele Knudson; 'Bubba Hughes'
Cc: Diane Schleicher; Dianne Otto; Dana Braun
Subject: RE: Laundry facility on Butler
Steele,
I appreciate your meeting with Carrie and working out a solution for this site. Also, thanks Diane for your
support in resolving this matter.
During my brief interaction with Carrie she has been very complimentary to Diane O. and others at the
city for helping with this problem.
Realizing that you are in a position that often quite difficult, I know that you'll continue learning the
community, the codes and the value of your staff in working together.
Sincerely,
Shirley
From: Steele Knudson [sknudson @cityoftybee.org]
Sent: Friday, October 28, 2011 3:26 PM
To: 'Bubba Hughes'; Shirley Sessions
Cc: Diane Schleicher; Dianne Otto; Dana Braun
Subject: RE: Laundry facility on Butler
I just met with Carrie.
We will not require a new site plan.
The tanks will be located on the east end of the building on an existing slab.
I am going over the tree ordinance to determine what requirements need to be met after the removal of
two palms.
Original Message
From: Bubba Hughes [mailto:BHughes @cbrhlaw.com]
Sent: Friday, October 28, 2011 1:57 PM
To: Shirley Sessions
Cc: Diane Schleicher; Steele Knudson; Dianne Otto; Dana Braun
Subject: Re: Laundry facility on Butler
Hello all. Is this covered or should I call Carrie?
Thanks
Sent from my iPhone
On Oct 28, 2011, at 10:22 AM, "Shirley Sessions" <ssessions @uwce.org> wrote:
> Bubba,
>
1
> Thanks for taking the time to reply to this while out of town. I discussed this briefly with Diane yesterday
and we both agreed that at the very least, contacting Carrie or stopping by the site and letting her know
something today is crucial - given the timeline for future planning.
>
> Hopefully you and Diane /Steele have, or will have, an opportunity to deal with this and engage Carrie
in a conversation and direction today.
>
> All the best,
> Shirley
>
> From: Bubba Hughes [BHughes @cbrhlaw.com]
> Sent: Thursday, October 27, 2011 12:29 PM
> To: Shirley Sessions; Diane Schleicher
> Cc: sknudson @cityoftybee.org; dotto @cityoftybee.org; Dana Braun
> Subject: RE: Laundry facility on Butler
>
> I am somewhat familiar with this as I received an email exchange after I left. It did not include drawings
though so I could better understand what is going on but in essence since the site plan was approved, the
decision was made to change the location of propane tanks onto an existing slab that was not known to
be present when the plan was originally submitted. There was a slab to be installed for the tanks on the
other side of the building but that has changed.That change does represent an exterior change on the
structure which under the ordinance would usually call for s revised site plan to go through the process. It
was not clear to me whether the originally intended slab - which I think there was to be built, will not now
be built & if not whether that makes a difference to the requirement.I know Carrie feels that the revised
plan is of lesser impact to neighbors & she may be correct but neighbors could disagree & I would not
really be in a position to assess that without a diagram or something. I do not think the ordinance exempts
that technically even if that is the case.
> Basically, I was hoping to be able to address this when I got back & told Dana I would & did not seek
further details from Steele or Dianne. I will be glad to call Steele/ Dianne & get a better understanding &
give my thoughts at that time.
>
> Thanks
>
> Bubba
>
> Original Message
> From: Shirley Sessions [mailto:ssessions @uwce.org]
> Sent: Thursday, October 27, 2011 12:05 PM
> To: Shirley Sessions; Bubba Hughes; Diane Schleicher
> Cc: sknudson @cityoftybee.org; dotto @cityoftybee.org; Dana Braun
> Subject: RE: Laundry facility on Butler
>
> Dana
>
> I'm copying you on this as a courtesy and if you are familiar with the matter, please feel free to weigh in!
>
> From: Shirley Sessions
> Sent: Thursday, October 27, 2011 12:03 PM
> To: bhughes @cbrhlaw.com; Diane Schleicher
> Cc: sknudson @cityoftybee.org; dotto @cityoftybee.org
> Subject: Laundry facility on Butler
>
> Hi Diane,
>
2
> It has come to my attention that the facility on Butler and Jones (Carrie & Amy's business) is in a holding
pattern. As I understand the situation in question, the owners are awaiting to hear from the city on
specific ordinance language that requires them to pay additional fees to locate temporary propane
tanks for operational needs.
>
> Based on the details that I have pried into, it would appear that we owe an answer to them ASAP - I
should think tomorrow (Friday) would be a reasonable time to resolve this since it seemingly has been
going on for a month?
>
> In situations like this doesn't our planning /zoning director go on site to discuss, and help plan or resolve
these types of issues? Has this happened?
>
> Many thanks for your attention to this matter.
>
> Shirley
****************************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
* **
This email and any files transmitted with it are confidential and intended solely for the use of the individual
or entity to whom they are addressed. If you are not the named addressee you should not disseminate,
distribute or copy this e -mail. Please notify the sender immediately by e -mail if you have received this e-
mail by mistake and delete this e -mail from your system. Please note that any views or opinions presented
in this email are solely those of the author and do not necessarily represent those of The City of Tybee
Island. The recipient should check this email and any attachments for the presence of viruses. The City of
Tybee Island accepts no liability for any damage caused by any virus transmitted by this email. City of
Tybee Island P.O. Box 2749 Tybee Island, GA 31328
****************************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
* **
3
WHITE RIVER ROCKS TO BE OPEN
GRADED WITH A MINIMUM SIZE EQUAL
TO OR LARGER THAN #57 STONE WITH
NO FINES PLACE DIRECTLY ON EXT'G
GRADE
\-EXTG
SLAB-
4' -10"
4 - 120 GALLON PROPANE TANKS -
NEW TANKS TO BE SUPPORTED BY
EXISTING PAD APPROVED BY TANK
SUPPLIER AND ANCHORED TO GROUND
BY ONE CABLE AND TWO SCREW IN
GROUND ANCHORS - OR APPROVED
EQUAL
(0)
REMOVE CONC. DRIVE AS
REQUIRED FOR NEW CONCRETE
DRIVE APRON. FIELD VERIFY.
r0 --7,c r
rev4s,t o.lS
2" WATER METER AND
PREVENTER IN VAULT
NEW 2" PE WATER
EXT'G SS LATERAL
4" GATE VALVE
AND BOX
PL,
ON
IN
GR
FIT
PR
EIE
City of'..,.aee Island • Community Develw __ent Dept.
Inspection Report
403 Butter Ave. • P.O. Box 2749 • Tybee Island, GA 31328
Phone 912.786.4573 ext. 114 Fax 912.786.9539
Permit No 1 I 0 5- S
Owner's Name ,pp \e e t( 1'r3p .
ff
Gen. Contractor \A/ h. t I O LA-i 23y1$.
Contact Information
Project Address
Scope of Work
Date Requested
Date Needed
Subcontractor fi1 r . L.
13 305"
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INTERNATIONAL
CODE COUNCIL
MEMBER
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(I 0 r U-- -t- 4- 0 prVQ '#e./ Q U h of
Inspector
Inspection n I e 1 e G✓ ,
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Date of Inspection 1 Z.-
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City of 1_ Island • Community Develop. nt Dept.
Inspection Report
403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328
Phone 912.786.4573 ext. 114 • Fax 912.786.9539
iaiii
IN`ERNAT!ONP
CODE COUNCIL`
MEMBER
Permit No. /1- ())-5-.
Date Requested /L -1,
Owner's Name 4/37//:/),C-.:,E./ Yip . Date Needed /Z L/ 1
Gen. Contractor Al 71t 1 nk -/ Subcontractor
Contact Information iii -c: 3/ 3 - 71u 5
Project Address ''7 f E,ZS J *`;-/.
Scope of Work (7c/Ja-c4Z, -Fv . - i/4-47t. 41-71,J
Inspector 1/4 Date of Inspection /• 1
Inspection r„.)(31 / l`%z1' - Pass E` Fail ` Fee
Inspection
/G Pass _Or ; ❑ Fee
Inspection )1 P6 1::-.J4 ! -
Pass
Fail Fee
Inspection Pass ❑ Fail ❑ Fee
CHATHAM COUNTY D UIRE TMENT OF BUILDING SAFET ,- REGULATORY SERVICES
SAFETY INSPECTION DIVIS,
FOR THE CITY OF TYBEE ISLAND
YEAR OF
APPROVED
DISAPPROVED
You are hereby notified that this is an Official Order of the County Fire Marshall, stating the defects
found to exist in the referenced structure, and further requiring that you, as owner, agent or person in
charge of structure, shall have days to complete specified repairs or improvements.
Owner /�t���:7 / / 2 7.7t / .$
-
Educational Day Care
Residential Hazardous
DATE / 2///
Business Phone
Occupant Load
Name of Facility
Address L 07
Occupancy:
1. Number of Exit Doors
2. Blocked
3. Exit Sign
4. Emergency Lights
5. Panic Hardware
6. Self- Closing Device
7. Fire Alarm
8. Smoke/Heat Detectors
9. Sprinkler System
10. Standpipe
Assembly
are Home Mercantile
Storage
Factory
2---
Locked OK ✓�
Good Unsatisfactory
Good Unsatisfactory
Good Unsatisfactory
Good Unsatisfact ry
Yes No V
Yes No )(
Yes No
Yes No
101 -SEC 5
101 -SEC 5
NA 101 -SEC 5
NA 101 -SEC 5
NA 101 -SEC 5
NA
NA NFPA 72
NA NFPA 73
NA NFPA 13
NA ,< NFPA 13
NFPA 10
NFPA 10
NFPA 96
'$ 11. Number of Fire Extinguishers Proper Type?
Inspected/Charged Yes No NA
12. Fixed Hood System Yes No ✓ NA
13. Date of Last Service n)lfl (REQUIRED EVERY 6 MONTHS)
14. Electrical Good ✓ Fair Unsatisfactory
15. Overloaded Sockets /Outlets Yes No
16. Missing Electrical Covers Yes ■ No
17. Other (explain)
NFPA 70
NFPA 70
NFPA 70
18. Excessive Storage of Combustibles Yes No - NFPA 30
List Details
YJ 7:-1L....w
7th4-0 IX. i..:i\ Q4—` +.
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N,�G -,= r3 .,....Y l�cv: , wU i3 j
The signature below of Owner, Occupant, Agent, signifies Insp , as made.
Owner /Occupant/Agent Signature / /tham County Fire Marshall
C:\Documents and Settings\coastatVlocal Settings\Temporary Internet Fes \Content.IES\119AI391\ Fire %20lnspection %20Form(1].doc
City of _iee Island • Community Develop....ynt Dept.
Inspection Report
403 Butler Ave. • P.Q. Box 2749 • Tybee Island, GA 31328
Phone 912.786.4573 ext. 114 Fax 912.786.9539
Permit No. //-1)44
Owner's Name
Gen. Contractor 1
Contact Information; Li ' L .
Project Address 46 7 ; , 1 S ed.-7Z-
/
Scope of Work,n // fit f' J
Inspector '1/0
Date Requested
Date Needed
Subcontractor , 5
Inspection
Inspection
lbw*
INTERNAPONAL
CODE COUNCIL
MEMBER
Date of Inspection /
J,41-
Pass
Fee
Pass ❑ Fail EJ Fee
Inspection - Pass Fee
Inspection
Pass ❑ Fail ❑ Fee
City of 1,..iee Island • Community Develop...ant Dept.
Inspection Report
403 Butler Ave. • P.Q. Box 2749 • Tybee Island, GA 31328
Phone 912.786.4573 ext. 114 • Fax 912.786.9539
INTERNAT @NAL
MUM:
MEMBER
Permit No. \ - 0 5 S Lo Date Requested H-\5"-"d
Owner's Name Au\ Z'i�k.a -\ Date Needed l I - 1 t0 - ( t
1 t:l G en. Contractor � h �\OW C,n St • Subcontractor Qr'1/41 \- ASP S J r� • ns
Contact Information - f...,1 -4 -= iCJr= . 4 1 - 3 2).3
Project Address 4 01 c, f S4 .1-
Scope of Work (� 1 n J €X i a1 C I Q n ci
r1
Inspector Date of Inspection
Inspection
Pass
Fail EI F
Z004 r"--)T.,:
Inspection Pass (""j Fail El Fee
Inspection Pass El Fail EJ Fee
Inspection Pass ❑ Fail ❑ Fee
City of • .,ee Island • Community Develop...ent Dept.
Inspection Report
403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328
Phone 912.786.4573 ext. 114 • Fax 912.786.9539
INTERNATIONAL
CODE COUNCIL
MEMBER
I -05�� ' L-
Permit No. Date Requested y': - ;{ . 1
Owner's Name A\d Date Needed 1 1 - 1 5* --
1 1 � QO?54. Gen. Contractor \ j h , Ot Subcontractor "PIv/n : ,,
Contact Information as- c aS l\ 2-3833
Project Address 9- (f) ; C 5 S4-.
Scope of Work 0- 0 I^ V er-}- 4" 0 r-, V Q 't-eJ \ounar,
Inspector %/ I Date of Inspection /7 ` Orti.
Inspection (36:5 \
J S\ 1 n Pass El Fail p z)
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Inspection Pass ❑ Fail Fee
Inspection Pass Fail ❑ Fee
Inspection Pass ❑ Fail ❑ Fee
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City of 'i ,ee Island • Community Develop. int Dept.
Inspection Report
403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328
Phone 912.786.4573 ext. 114 • Fax 912.786.9539
Permit No. //--U
30 a r^
it�
INTERNATIONAL
CODE COUNCIL
MEMBER
__,' 2 Date Requested /-12 /7/
Owner's Name /.i i/" / 7 J Date Needed i ‘- - 1 1
Gen. Contractor /V,� // f Li] Subcontractor
Contact Information iti:/-1-: !/ 5 ' %:�S
Project Address 47,-,/ j I 1 %" �7'
f
Scope of Work Z-",)
Inspector 'T I/1 Date of Inspection,
Inspection �' "-- L�'.J Pass F • Fee
Inspection Pass ❑ Fail LJ Fee
Inspection Pass Fail El Fee
Inspection Pass ❑ Fail ❑ Fee
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