HomeMy Public PortalAbout11-0615 ShambayatiDATE ISSUED: 11 -8 -2011
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
REPLACE ROOF SHINGLES
5 SEVENTEENTH PL
LRAJ SHAMBAYATI
554 SUNCREST BLVD
SAVANNAH GA 31410 -2215
IRAJ SHAMBAYATI
554 SUNCREST BLVD
SAVANNAH GA 31410 -2215
P
$ 404.00
$3,300.00
PERMIT #: 110615
TOTAL BALANCE DUE: $ .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
Fron:GITY OF TYBEE ISLAND
o tS
II -tivxrki
Location: t" j 1
912 786 9539 10(11/2011 12:38 #095 P.001/004
CITY OF TYBEE ISLAND, GEORGIA
APPLICATION FOR BUILDING PERMIT
NAME
C*Nr.
PIN #
ADDRESS
TELEPHONE
Owner
Architect
or Engineer
Ty1oce. Selrid,
c4 rKli oW , 17+h PZ aec.
Building
Contractor._
(Check all that apply)
❑ Repair
• Renovation
❑ Minor Addition
1.11 Substantial Addition
❑ Other R of ti'eMa it
Details of Project: t P
❑ Residential
❑ Single Family
❑ Duplex
❑ Multi - Family
❑ Commercial
2 or e
❑ Footprint Changes
❑ Discovery
❑ Demolition
In
Estimated Cost of Construction: S CO
(I)
(2)
(3) B
Propose
Remarks:
nstruction Type
Wood Frame
ood & Masonry
k Veneer
use:
ATTACH A
following info
(Enter appropriate number)
(4) Masonry (6) Other (please specify)
(5) Steel & Masonry
Y OF THE CERTIFIED ELEVATION SURVEY OF LOT and complete the
don based on the construction drawings and site plan:
# Units
Lot Area
# Ofx str t parking sp es
Trees 1 ' atcd & listed on : ite plan
Accos
Driv ay (ft.)
Set • acks: Front
# Bedrooms # Bathrooms
Living space (total sq. ft.)
With culvert? rt
Rear
With swalc? _
Sides (L) (R)
# •tories Height Vertical distance measured from the average adjacent
grade of the building to the extreme high point of the building, exclusive of chimneys, heating
units, ventilation ducts, air conditioning units, elevators, and similar appurtances.
7/£ d 6£56 98L 266
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From:CITY OF TYBEE ISLAND
912 786 9539 10/31/2011 12:38 #095 P.002/004
During construction:
On -site restroom facilities will he provided through DYE CGn ciota 1,005
On -site waste and debris containers will be provided by
Construction debris will be disposed by ?,!..92) by means of
1 understand that 1 must comply with zoning, flood damage contrrpl. puildinn. fire, shore
frutections and wetlands ordinances. FEMA regulations and all applicable codes and regulations.
I understand that the lot must be staked out and that the stakes will be inspected to ensure that the
setback requirements arc met. 1 understand also that a certified plot plan showing elevation must
be attached to this application and that an as -built elevation certification is due assoon as the
habitable 1( qor Icvcl is_establ,thsd. Drainage: I realize that I must ensure the adequacy of
drainage of this property so that surrounding property is in no way adversely affected, I accept
responsibility for any corrective action that may be necessary to restore drainage impaired by this
permitted construction.
Datc: 012./26 Jf Signature of Applicant: 1 GG \I(10.CM/Ledf
Note: A permit normally takes 7 to 10 days to process.
The following Is to be completed by City personnel,
Zoning certification NFIP Flood Zonc
Approved rezoning/variance?
Street address and number: New Existing
is it in compliance with City map?
If not, has street name and/or number been reported to MPC?
FEMA Certification attached
State Energy Code Affidavit attached
Utilities and Public Works:
Describe any unusual findings)
Access to building site
Distance to water main tap site
Distance to sewer stub site
Water meter size
Storm drainage
Approvals: Signature
Zoning Administrator
Code Enforcement Officer
Water /Sewer
Storm/Drainage
Inspections
City Manager
Work W , a rpt?S'r►l ►
,/4 d 6256 99L 266 << 6
Date
FEES / _ 2
Permit ICJ
Inspections
Water Tap
Sewer Stub
Aid to Const. T
TOTAL
pz�W u1ooutl XWIJit3d 26 :£6 80-66-6602
From:CiTY OF TYBEE ISLAND
912 786 9539 1013112011 12 :39 8095 P.0031004
LEAD -BASED PAINT
Adapted from ale://www.ece,gosiAtadqubsIrenevoto,Men. Please use that site to access the following information.
Information for Property Owners of Rental Housing, Child - Occupied Facilities
Property owners who renovate, repair, or prepare surfaces' for painting in pre-1978 rental housing or space
rented by child -care facilities must, before beginning work, provide tenants with a copy of EPA's lead hazard
Information pamphlet gelleeitte-Eigitetant_Ladedarlaf—kdRallatfialar—F-MO.U.ltaie.-CarleeCfcl-ta.
anti Schools. Owners of these rental properties must document compliance with this requirement. EPA's sample
9.;,EISal=1 lao4r (Gr?sI may be used for this purpose.
After April 22, 2010, property owners who perform there projects in pre -1978 rental housing or space rented
by child -care facilities must be certified and follow the lead-safe work practices required by EPA's Renovation,
Repair and Remodeling rule. To become certified, property owners must submit an atiollcajlpn for 1k
sallianiga and fee payment to EPA. The Agency has up to 90 days after receiving a complete request for
certification to approve or disapprove the application.
Property owners who perform renovation, repairs, and painting jobs in rental property should also:
• Take training to loam how to perform lead -safe work practices.
• Learn the lead laws that apply regarding certification and lead -safe work practices beginning In April 2010.
• Keep records to demonstrate that you and your workers have been trained in lead -sate work practices and that you followed lead -
safe work practices on the job. To make recordkeeping easier, you may use the sample nee tt snlno_ch ckilst that EPA has
developed to help contractors comply with the renovation recordkeeping requirements that took effect April 2010.
• Read about how to comply with EPA's rule in the ,(rPA Smell Entity Cprppl(ance ryide to enoynte,loht
• Read about how to use lead-safe work practices in EPA's
Information for Homeowners Working at Home
If you are a homeowner performing renovation, repair, or painting work In your own home, EPA's RRP rule does not cover your project.
i'4owcvcr, you have the uitlmete responsibility for the safety of your family or children in your care. If you are living in a pre -1978 home
and planning to do painting or repairs, please read a copy of EPA's : •. • r • -. , • .• r,• mathzn for fpm
aprefrpvlders, end SChoolz lead hazard information pamphlet, You may also want to call the National Lead Information Center at 1 -800-
424 -LEAD (5323) and ask for more information on how to work safely in a home with lead -based paint,
Information for Tenants and Families of Children under Age 6 in Child Care Fadlitles and Schools
As a tenant or a parent or guardian of children in a child care facility or school, you should know your rights when a renovation job is
performed In your home, or In the child care facility or school that your child attends.
• Before starting a renovation In residential buildings built before 1978, the contractor or property owner Is required to have tenants
sign a jaceLtgarmiltggLascidsurejsm which indicates that the tenant received the Renovate Right lead hazard information
pamphlet.
• Beginning in Deccrntrer 2008, the contractor must also make renovation information available to the parents or guardians of
children under iige six that attend child care facilities and schools, and to provide to owners and administrators of pre -1978 child
rare facilities and schools to be renovated a copy of EPA's &eoQle..1tr t3(4 : Irno*jrlpl�q{Id P d !n rmrrtidn let flrmlft•• '. Child
ar Pmylders and,Scho ee lead hazard Information pamphlet.
Information for Contractors
As contractor, you play an important role in helping to prevent lead exposure. Ordinary renovation and maintenance activities can create
dust that contains lead. By following the lead -safe work practices, you can prevent lead hazards. Contractors who perform renovation,
repairs, and painting jobs In pre -1978 housing and child- occupied facilities must, before beginning work, provide owners, tenants, and
child-care facilities with a copy of EPA's lead hazard information pamphlet $enoyate$ghfr Impoaant Lead Ward Information for Tamil/CS.
aNd ,r P rite z and ools. Contractors must document compliance with this requirement. EPA's Qre-renovatipf d_Lout-e form may
be used for this purpose. Understand that after April 22, 2010, federal law will require you to be certified and to use lead -safe work
practices. To become certified, renovation contractor✓ must submit an application and fee payment to EPA. See: Aoolicaj9op Jar tjrrh
certification. The Agency has up to 90 days after receiving a complete request for certlflcatlon to approve or disapprove the application.
Contractors who perform renovation, repairs, and painting jobs should also:
• Take training to learn how to perform lead -safe work practices.
• find a_trainlne_oravider that has been accredited by EPA to provide training for renovators under EPA's Renovation, Repair,
and Painting (RRP) Program. Please note that If you previously completed an eligible renovation training course you may
take the 4 -hour refresher course instead of the 8 -hour Initial course from an accredited training provider to become a
certified renovator, Click heee for a of eltolble courses,
• Provide a copy of your EPA or state lead training certificate to your client.
• Tell your client what lead-safe methods you Wilt uSC to perform the job.
▪ Learn the lead lawe that apply to you regarding certification and lead -sate work practices, beginning In April 2010.
• Ask your client to share the results of any previously conducted lead tests.
Provide your client with references from at least three recent jobs Involving homes built before 1978.
• Keep records to demonstrate that you and your workers have been trained in lead-safe work practices and that you followed lead -
safe work practices on the job. To make recordkeeping easier, you may use the eempjgerzordkeeo?1nd_checkllst that EPA has
developed to help contractors comply with the renovation recordkeeping requirements.
• Read about how to comply with EPA's rule in the EPA SfplI Entity demotion +uld to RenovateRight.
• Read about how to use lead-safe work practices in EPA's Seegseteeeffeeeittee.egmeeee Reralir tCcL pinfiny.
• .
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Printed Name
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Date
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From :CITY OF TYBEE ISLAND
912 786 9539 101/1/2011 12:40 #095 P.004/004
Perm it Acknowledgement of
Ashestos /Environmental Notification to Georgia EPD for
projects Involving Demolition, Wrecking, or Renovation
The undersigned hers by a;cknvwkdgcs 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 tiling 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 arc 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.
2.6 V
ndcrsigne Date
[KA) SviaAbaYawit'
Printed Name
Office Use Only:
Project Address:
Permit IVum&er:
d 6£56 99L 266
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TX Result Report
P 1
10/31/2011 12:41
Serial No. CH35228060004
TC: 286150
Destination
Start Time
Time
Prints
Result
Note
8974581
10 -31 12:38
00:02:45
004/004
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: RX from TEL, NG: Other Error, Cont: Continue, No Ans: No Answer,
Refuse: Receipt Refused, Busy: Busy, M- Full:Memory Full,
LOUR:Receiving length Over, POVER:Receiving page Over, FIL:File Error,
DC:Decode Error, MDN:MDN Response Error, DSN:DSN Response Error.
5 11 *L p . rcroo -P
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Skain4 a1, (9I2-o-3z2)
ev a :( -Cr &i 10dd i0 -3I -o1
C `
_I
1 S s v e Cl„
Location:
CITY OF TYBEE ISLAND, GEORGIA
APPLICATION FOR BUILDING PERMIT
NAME
ADDRESS
PIN #
TELEPHONE
Owner
Architect
or Engineer
Building
Contractor
(Check all that apply)
0 Repair
n Renovation
Minor Addition
J Substantial Addition
F-1 Other
Details of Project:
Residential
Single Family
Duplex
Multi- Family
Commercial
Footprint Changes
F-1 Discovery
n Demolition
Estimated Cost of Construction: S
nstruction Type (Enter appropriate number)
(1 Wood Frame (4) Masonry (6) Other (please specify)
(2) ood 88 Masonry (5) Steel Sr Masonry
(3) B k Veneer
Propose • use:
Remarks:
ATTACH A •: ' Y OF THE CERTIFIED ELEVATION SURVEY OF LOT and complete the
following info . ' : tion based on the construction drawings and site plan:
# Units # Bedrooms # Bathrooms
Lot Area Living space (total sq. ft.)
# Off -str et parking sp es
Trees 1 aced Sc listed on , ite plan
Acces
Driv- ay (ft.) With culvert? With swale?
Set. acks: Front Rear Sides (L) (R)
# - tories Height Vertical distance measured from the average adjacent
grade of the building to the extreme high point of the building, exclusive of chimneys, heating
units, ventilation ducts, air conditioning units, elevators, and similar appurtances.