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HomeMy Public PortalAbout11-0655 Hays_1of3Building Pennit Number C7 ;# : 1384696 F ILEL, FOR RECORD NONCONVERSION AGREEMENT12 O1:48pm FOR STRUCTURES IN THE FL( tib ST i!"tie . +.s_e;°, Clerk Superior Court of Chatham County Address of Propealya t tUrn tad $1 , i a- L /U , CA.) - ,6SS PIN G{ — OD!i -o t.( -O FIRM Zone /4 BFE 1 Z feet (NAVD) Panel Number Q D D t , effective date n t Property Owner(s) / J E `; JO 1411. y S re, -1 Contractor ( b Rerni - Sc- 1wIc.G In accordance with the Flood Damage Prevention Ordinance of the City of Tybee Island, Georgia, the Property Owner agrees to tin— following: =— 1. That the enclosed area below the Base Flood Elevation shall be used solely for parking of vehicles, limited storage, or access to t building, and will never be used for human habitation without first becoming fully compliant with the Flood Damage Prevention 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. nature of Property Owner Printe fbvs ame of Pro erty Owner Signa l!of 'rope Printed Name of Property Owner Da Date / STATE OF GEORGIA COUNTY OF CHATHAM I hereby certify that on this _q& day of J(ilUt..e,--) personally appeared ,j ehrt Gat S a - J Arty the person whose name is subscribed to the foregoing insttument, therein set forth, and that it is his act and deed. In witness whereof have set my hand and :.,tarial Seal. NOTAR My Commission e WITNESS SIGNATURE Printed Name Address 3 , 20 I , before me, a Notary Public o' • f Georgia, , known to me, or lsfactorily pr en to be cuted i • ; .oses who acknowledged that he /she has e LATOYA BYRD Notary Public, Chatham County, Q My Commission Expires October 28, too staA4 (seal) Note: 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 satisfy all of the above conditions and requires proper recordation in the land records of Chatham County, Georgia. City of T, -ee 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 X11►\ INTERNATIONAL CODE COUNCIL MEMBER Permit No. H-0(055- Date Requested 2 -) 12 Owner's Name (? y s Date Needed 2-2 ( 2- Gen. Contractor , c_ ay d 'S'e ea ; r Subcontractor QYv,4e. Contact Information `J d ih n ?0 - D (0 (0 J Project Address ) J l, , 4 e, flok L r. . Scope of Work 'fin (1 oSei 9 r DJ /NJ --C / o Inspector I/`3 Date of Inspection 2 .-3 sr Inspection -r , n c3 el ec . Pass Fail El Fee �i� �J� l k G: 1 ►' i Inspection Pass ❑ Fail EJ Fee Inspection Pass El Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee City o ,iee Island • Community Develo, ent Dept. Inspection Report 4 03 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 Phone 912.786.4573 ext. 114 • Fax 912.786.9539 INTERNATIONAL CODE COUNCIL' MEMBER Permit No. //- 0'-':<>_"-- '- Date Requested / i Owner's Name /- S Date Needed z/ y Gen. Contractor _, ic=y -� , /�- AL, 7_ J ;,,� . Subcontractor 3�-%i�ii -e• Contact Information .-/ / >/f,J 4,J . c2G Project Address AI 7" /42//i -6-. U' . L/4.4, . Scope of Work ,E:",Jci) 3/f G v.J_ / Sri p , Inspector '-'-2/ q Date of Inspection 1/ 7_, Inspection /,_- / - i� Pass Fail Fee Inspection /A1 • 2 Pass Fee Inspection Pass El Fail Fee Inspection Pass ❑ Fail ❑ Fee City of l ,4ee 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 Permit No. / / - S Date Requested Owner's Name Date Needed tai % Ake" INTERNATIONAL CODE COUNCIL' MEMBER Gen. Contractor L im / >� 4/W- Subcontractor Contact Information ) 4 . Project Address it/ 1,0//j.:-/. . /At"- 247t Scope of Work /.;4---- �l%G -/c)! / vv,-).d /- / Inspector % / "1 Date of Inspection 1 / // /L -a/��` Inspection Pass Fail Fee ) Inspection FA /4N Pass ❑ Fail Fee J Inspection Pass ❑ Fail Fee Inspection Pass ❑ Fail ❑ Fee City of oee Island • Community Develoi,..ent Dept. Inspection Report 403 Butler Ave. • P.C. Box 2749 • Tybee Island, GA 31328 Phone 912.786.4573 ext. 114 • Fax 912.786.9539 Permit No 1/ Owner's Name , Date Requested / Z/ / / / Date Needed / 2 2-2: /! Nemsni INTERNATIONAL CODE COUNCIL' MEMBER Gen. Contractor 4K /'i Subcontractor Contact Information ■../()�� Project Address Scope of Work Inspector Inspection 641`. L �fer. Date of Inspection Inspection Pass fail Fee ; 1 f� ` _.., 1 L took. A4 t1/45k(A-io. n ` i o Pass ,1—I Fee Inspection Pass El Fail El Fee Inspection Pass ❑ Fail ❑ Fee DATE ISSUED: 12 -5 -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 ENCLOSE GROUND FLR/ELEC 4 WHITE OAK LANE PERMIT #: 110655 SPACE t'•E V Ft. : : '...: ;Ti - N 0E-Zone) Hydrostatic ven ; Vic_ r :ii;V• !r :,tasure In JOHN HAYS enclosed spc? {i„'.? ?',VBIi'.5 1 scL:Te Inch of PO BOX 867 vent requ;:: ::r:: t ut of floor area, TYBEE ISLAND GA 31328 Bottom of 'v. • irlot of the grade 571- 235 -0057 dicYstion, t`�',.. opposite waits to __permit water 1c. RICHARD'S REPAIR SERCE 255 AURIGA BLVD BLOOMINGDALE GA 31302 SPACE Ft P $ 93.00 $5,958.00 Hydrostatic vent, encfosei sprr• vent regr` Bottom of etaystion, permit w ^.,tee .ti iAE-Zone! ... • , . : rassure In Inch of ...... a` floor area • i of the grade ;ppasite ways to TOTAL BALANCE DUE: $ 93.00 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: AU. WIRING, SERVICE INCLUDED MUST BE COPPER N� ALUM±UNM ALLOWED Gection 9, sub- section B -2 -A Tybee Land Development Code P. 0. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328 (912) 786 -4573 - FAX (912) 786 -9539 www.cityoftybee.org �2COrd -� WOr1 aoh•vefSion AVreary 4 r t. E re-4 CITY OF TYBEE ISLAND, GEORGIA APPLICATION FOR BUILDING PERMIT Location: L Lok Oat NAME ADDRESS PIN# oo - D/ -0/3 TELEPHONE Owner Joe#N f iebv6 /C f-{At5 w WHIT 0,4-k LfV. TyPer ZS, DI Ct►% 31326 C 11) 014735-'6057 Architect or Engineer - Building Contractor RtC1kike& .12k 4941k. Ee -VtCE LLG 255 Av+l't alviD c0 61- oon,‘nX— °ALA 3(32 1Z `7U�i -0s20 (Check all that apply) 2 Repair Residential Renovation Single Family n Minor Addition ❑ Duplex ❑ Substantial Addition ❑ Multi- Family ❑ Other n Commercial Details of Project: n Footprint Changes n Discovery n Demolition CAg Poe,-C' WPM gE►p1k_GrnENi Estimated Cost of Construction: $ Construction Type (1) Wood Frame (2) Wood & Masonry (3) Brick Veneer Proposed use: Remarks: �IXr lrl� 44- Libb0 -�-` 3 SAS a e CSee r o- 1 SA) (Enter appropriate number) (4) Masonry (6) Other (please specify) (5) Steel & Masonry G1YlrX S'%ora L ATTACH A COPY OF THE CERTIFIED ELEVATION SURVEY OF LOT and complete the following information based on the construction drawings and site plan: # Units 1 # Bedrooms 3 # Bathrooms 3 Lot Area y, 5-0o - 51c Living space (total sq. ft.) S23 -sf # Off - street parking spaces Trees located & listed on site plan Access: 5.ree -T Driveway ZO (ft.) With culvert? With swale? Setbacks: Front Rear Sides (L) (R) # Stories , Height 4i6 / 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. CITY OF TYBEE ISLAND BUILDING & ZONING DEPARTMENT P.O. Box 2749, Tybee Island, GA 31328 Phone (912) 786 -4573 • Fax (912) 786 -9539 ELECTRICAL PERMIT APPLICATION & TEMPORARY SERVICE AFFIDAVIT Date (/ /'37/ // New Work i/ Replacement Location of work (street address) �—/ �,(JH-t d¢/c 6.,41j6- ' j�ge 15c,,4 -kiD �6 /1 '3l 326 Contractor Address of Contractor Telephone Property Owner J ui+ti 1-1445 Date work will be ready for inspection, if known Estimated cost of construction $ 11 3 5-3 Telephone (q / z) e-i eo - O 4.6 3 A/C Unit and Heat Pump / Attic Ventilation Fan Bell Transmitter — low voltage Border /Outline Lighting Building Saw Exit Lights — life safety Heat Pump Meter Box / Motor(s): hp (L( Outlets — 110 volts circuit Parking Lot Lights /q Pool Lights — grounding Range — commercial Telephone (q / z) e-i eo - O 4.6 3 Permit Number ALL WIRING, SERVICE INCLUDED, MUST BE COPPER. NO ALUMINUM ALLOWED. APPLICATION FOR TEMPORARY SERVICE REQUEST In requesting temporary electrical service, the undersigned understands and agrees: SERVICE EQUIPMENT— DISCONNECT' 1. Connection of temporary electrical service does not remove the requirement MEiTA=plat of Georgia minimum construction codes. Means shall be provided to diseonneel 2. Temporary electrical power is intended for completion of the construction p M t @ski I t i�frl�iil =r struei r6PP installed within the structure. from the service- entrance conductors. 3. Issuing approval for temporary power connection does not constitute approval to occupy the structure. A Certificate of Occupancy must be issued by the City of Tybee Island prior to any occupancy. 4. The owner and contractor are hereby held responsible for any violations of this policy. A violation of this policy may result in disconnection of the electrical service until all violations and deficiencies are corrected. wner /Contractor Signature V Date J© f-F•N /1114-V S Owner /Contractor Printed Name • /1 /2°Y /j( APPROVAL Fee Building Official Date • Range Hood — commercial / Service: 20 amps Sign Circuit - wattage Smoke Detector — low voltage Spa or Tub — grounding Special Outlet Swimming Pool — grounding Water Heater / Welder — 220 volts circuit Well Pump — grounding X -ray /q Other (t-( pcor FLuv,?.. 5c - &T Permit Number ALL WIRING, SERVICE INCLUDED, MUST BE COPPER. NO ALUMINUM ALLOWED. APPLICATION FOR TEMPORARY SERVICE REQUEST In requesting temporary electrical service, the undersigned understands and agrees: SERVICE EQUIPMENT— DISCONNECT' 1. Connection of temporary electrical service does not remove the requirement MEiTA=plat of Georgia minimum construction codes. Means shall be provided to diseonneel 2. Temporary electrical power is intended for completion of the construction p M t @ski I t i�frl�iil =r struei r6PP installed within the structure. from the service- entrance conductors. 3. Issuing approval for temporary power connection does not constitute approval to occupy the structure. A Certificate of Occupancy must be issued by the City of Tybee Island prior to any occupancy. 4. The owner and contractor are hereby held responsible for any violations of this policy. A violation of this policy may result in disconnection of the electrical service until all violations and deficiencies are corrected. wner /Contractor Signature V Date J© f-F•N /1114-V S Owner /Contractor Printed Name • /1 /2°Y /j( APPROVAL Fee Building Official Date • During construction: On -site restroom facilities will be provided through HMI f, oN F,.,e5 Fac 1 + J i is On -site waste and debris containers will be provided by Construction debris will be disposed by A ClUvok fact by means of T &tz.„K. / AD S cev ro t7 s posy L -i ce! I understand that I must comply with zoning, flood damage control, building, fire, shore protections and wetlands ordinances, FEMA regulations and all applicable codes and regulations. I understand that the lot must be staked out and that the stakes will be inspected to ensure that the setback requirements are met. I understand also that a certified plot plan showing elevation must be attached to this application and that an as -built elevation certification is due as soon as the habitable floor level is established. Drainage: I realize that I must ensure the adequacy of drainage of this property so that surrounding property is in no way adversely affected. I accept responsibility for any corrective action that may be necessary to restore drainage impaired by this permitted construction. Date: J� N O (/ 20 1( Signature of Applicant: Note: A permit normally takes 7 to 10 days to process. The following is to be completed by City personnel: Zoning certification Approved rezoning /variance? Street address and number: New Is it in compliance with City map? If not, has street name and/or number been reported to MPC? FEMA Certification attached State Energy Code Affidavit attached Utilities and Public Works: Describe any unusual finding(s) NFIP Flood Zone Existing Access to building site Distance to water main tap site Distance to sewer stub site Water meter size Storm drainage Approvals: Signature Date Zoning Administrator Code Enforcement Officer Water /Sewer Storm/Drainage Inspections City Manager FEES Permit Inspections Water Tap Sewer Stub Aid to Const. TOTAL R LEAD -BASED PAINT Adapted from http: / /www.epa.gov/lead /pubs /renovation.htm. Please use that site to access the following information. Information for Property Owners of Rental Housing, Child- Occupied Facilities Property owners who renovate, repair, or prepare surfaces for painting in pre -1978 rental housing or space rented by child -care facilities must, before beginning work, provide tenants with a copy of EPA's lead hazard information pamphlet Renovate Right: Important Lead Hazard Information for Families, Child Care Providers, and Schools. Owners of these rental properties must document compliance with this requirement. EPA's sample pre- renovation disclosure form may be used for this purpose. After April 22, 2010, property owners who perform these projects in pre -1978 rental housing or space rented by child -care facilities must be certified and follow the lead -safe work practices required by EPA's Renovation, Repair and Remodeling rule. To become certified, property owners must submit an application for firm certification and fee payment to EPA. The Agency has up to 90 days after receiving a complete request for certification to approve or disapprove the application. Property owners who perform renovation, repairs, and painting jobs in rental property should also: • Take training to learn how to perform lead -safe work practices. • Learn the lead laws that apply regarding certification and lead -safe work practices beginning in April 2010. • Keep records to demonstrate that you and your workers have been trained in lead -safe work practices and that you followed lead - safe work practices on the job. To make recordkeeping easier, you may use the sample recordkeepinq checklist that EPA has developed to help contractors comply with the renovation recordkeeping requirements that took effect April 2010. • Read about how to comply with EPA's rule in the EPA Small Entity Compliance Guide to Renovate Right. • Read about how to use lead -safe work practices in EPA's Steps to Lead Safe Renovation, Repair and Painting. Information for Homeowners Working at Home If you are a homeowner performing renovation, repair, or painting work in your own home, EPA's RRP rule does not cover your project. However, you have the ultimate responsibility for the safety of your family or children in your care. If you are living in a pre -1978 home and planning to do painting or repairs, please read a copy of EPA's Renovate Right: Important Lead Hazard Information for Families, Child Care Providers, and Schools lead hazard information pamphlet. You may also want to call the National Lead Information Center at 1 -800- 424 -LEAD (5323) and ask for more information on how to work safely in a home with lead -based paint. Information for Tenants and Families of Children under Age 6 in Child Care Facilities and Schools As a tenant or a parent or guardian of children in a child care facility or school, you should know your rights when a renovation job is performed in your home, or in the child care facility or school that your child attends. • Before starting a renovation in residential buildings built before 1978, the contractor or property owner is required to have tenants sign a pre- renovation disclosure form, which indicates that the tenant received the Renovate Right lead hazard information pamphlet. Beginning in December 2008, the contractor must also make renovation information available to the parents or guardians of children under age six that attend child care facilities and schools, and to provide to owners and administrators of pre -1978 child care facilities and schools to be renovated a copy of EPA's Renovate Right: Important Lead Hazard Information for Families, Child Care Providers, and Schools lead hazard information pamphlet. Information for Contractors As a contractor, you play an important role in helping to prevent lead exposure. Ordinary renovation and maintenance activities can create dust that contains lead. By following the lead -safe work practices, you can prevent lead hazards. Contractors who perform renovation, repairs, and painting jobs in pre -1978 housing and child- occupied facilities must, before beginning work, provide owners, tenants, and child -care facilities with a copy of EPA's lead hazard information pamphlet Renovate Right: Important Lead Hazard Information for Families, Child Care Providers, and Schools. Contractors must document compliance with this requirement. EPA's pre- renovation disclosure form may be used for this purpose. Understand that after April 22, 2010, federal law will require you to be certified and to use lead -safe work practices. To become certified, renovation contractors must submit an application and fee payment to EPA. See: Application for firm certification. The Agency has up to 90 days after receiving a complete request for certification to approve or disapprove the application. Contractors who perform renovation, repairs, and painting jobs should also: • Take training to learn how to perform lead -safe work practices. • Find a training provider that has been accredited by EPA to provide training for renovators under EPA's Renovation, Repair, and Painting (RRP) Program. Please note that if you previously completed an eligible renovation training course you may take the 4 -hour refresher course instead of the 8 -hour initial course from an accredited training provider to become a certified renovator. Click here for a list of eligible courses. • Provide a copy of your EPA or state lead training certificate to your client. • Tell your client what lead -safe methods you will use to perform the job. • Learn the lead laws that apply to you regarding certification and lead -safe work practices beginning in April 2010. • Ask your client to share the results of any previously conducted lead tests. • Provide your client with references from at least three recent jobs involving homes built before 1978. • Keep records to demonstrate that you and your workers have been trained in lead -safe work practices and that you followed lead - safe work practices on the job. To make recordkeeping easier, you may use the sample recordkeepinq checklist that EPA has developed to help contractors comply with the renovation recordkeeping requirements. • Read about how to comply with EPA's rule in the EPA Small Entity Compliance Guide to Renovate Right. • Read about to us lead-safe work practices in EPA's Steps to Lead Safe Renovation, Repair and Painting. IF YOU'RE NOT tE %D SAj i <FRT1,14D .DISTURBING JUST SIX SQUARE FEET °COULD COST YOU .BIG TIME. Signature 4areti L , E- 1 Printed Name ig NOV .ZDl Date Permit Acknowledgement of Asbestos /Environmental Notification to Georgia EPD for Projects Involving Demolition, Wrecking, or Renovation The undersigned hereby acknowledges that the issuance of this permit does not in any way grant permission to the owner, owner's representative, or permit holder to proceed with demolition, wrecking, or renovation of a structure prior to the filing of any required ten (10) day "Project Notification for Asbestos Renovation Encapsulation or Demolition" form in accordance with the Georgia Asbestos Rules. The Georgia Environmental Protection Division administers the rules. In most cases, the rules require both the owner and the involved contractors to assure the portion of the building involved in the project is thoroughly inspected by an Accredited Asbestos Inspector for materials that contain asbestos; and the removal of the asbestos before renovation, wrecking, or demolition begins almost without exemption. Georgia EPD requires a completed demolition notification from be submitted 10 workings days in advance even if no asbestos is present in the building. Further guidance for regulatory compliance and contact telephone numbers are provided by the brochures entitled Asbestos & Renovation and Asbestos and Demolition. Other environmental issues such as asbestos removal techniques, lead abatement, ground contamination, or unusual site conditions may have EPD regulations that could affect the project. Undersigned Printed Name IF NoV 2011 Date Office Use Only: Project Address: Permit Number: i •.v�v�� gnu- IwL.n,.• 1 1►IP IVIVIYIGI\ 1 MvGIfl. 1 NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important Read the instructions on pages 1- 7. O.M.B. No. 3067 -0077 Expires July 31, 2002 SECTION A - PROPERTY OWNER INFORMATION BUILDING OWNER'S NAME True Integrity Construction BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bkig. No.) OR P.O. ROUTE AND BOX NO. #4 L here W h : {.t Oak I- r+ • For Ins nceCorripery use: Porgy Nurier. Company NAtC _Number...,..' CITY Tybee Island STATE Ga ZIP CODE 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot B Horse Pen Hammock Subdivision BUILDING USE (e.g., Residential, Non- residential, Addition, Accessory, etc. Use a Comments area, 1 necessary.) Residential LATITUDE/LONGITUDE (OPTIONAL) ( ##" - ##' - ##.## or ##.#####°) HORIZONTAL DATUM: ❑ NAD 1927 ® NAD 1983 SOURCE: ❑ GPS (Type): ❑ USGS Quad Map ® Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 135164 B2. COUNTY NAME Chatham B3. STATE Cam. B4. MAP AND PANEL NUMBER 0001 B5. SUFFIX c 86. FIRM INDEX DATE 06/17/86 B7. FIRM PANEL EFFECTIVE/REVISED DATE 08/17/86 88. FLOOD ZONE(S) A(8) B9. BASE FLOOD ELEVATION(S) (Zone A0, use depth of fkxxing) 12 810. Indicate the source of the Base Flood Elevation (BFE) data or base hood depth entered in B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Desabe): B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Desabe): B12. Is the bulking located in a Coastal Bailer Resources System (CBRS) area or Otherwise Protected Area (OPA) ?❑ Yes ® No Desigiation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Buil ing elevations are based on: ❑ Construction Drawings' ❑ Buiking Under Construction' ® Finished Construction 'A new Elevation Certificate will be requred when construction of the buiking is complete. C2. Bulking D'ragam Number 6 (Select the bulking dog am most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diga n accurately represents the building, provide a sketch a photogaph.) C3. Elevations — Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARJA, AR/AE, AR/A1 -A30, AR/AH, AR/AO Carplete Items C3. -a-i below according to the building c agam specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Camlents area of Section D or Section G, as appropriate, to docunent the datum conversion. Datum Conversion/Comments Elevation reference rnark used Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No o a) Top of bottom floor (inducing basement a enclosure) 10. 39 ft.(m) o b) Top of next higher floc 20 21 it(m) o c) Bottom of lowest horizontal structural member (V zones ony) N/A . _film) o d) Attached garage (top of slab) WA. _fL(m) o e) Lowest elevation of machinery ancYa equipment servicing the building (Desate in a Comments area) 15.59 ft(m) o f) Lowest adfacent (finished) Bade (LAG) 8.26 ft(m) o g) Highest adjacent (finished) Bade (HAG) 9. 54 ft(m) o h) No. of permanent openings (flood vents) within 1 R above adjacent Bade WA o ) Total area of all permanent openings (flood vents) in C3.h WA sq. in. (sq. an) 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 in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand s ., false statemenjy be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERT • n 0. ' . LICENSE NUMBER R.L.S # 1850 �T Registred !?r: Surveyor COMPANY NAME John 0. Parka Surveying ADDRESS P.O. Box 233 CITY Glenville STATE Ga ZIP CODE 30427 SIGNATURE DATE 01/26/06 TELEPHONE 1-912-826-5283 IMF-WIN 1 MI. I. m u.WC.I�WL7 l.Liry uiC- wnespununy invurmduun mom ecoon Pt. BUIONG STREET ADDRESS (Inducing Apt., Unit it B. No.) CR P.O. ROUTE AND BOX NO. 34 Lora Court CITY STATE ZIP CODE Rincan Ga 31326 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insuance agent/company, and (3) building owner. COMMENTS ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Section C must be completed. El . Bulking Diagam Number _(Select the bulking cfagam most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagam accurately represents the building, provide a sketch a photogaph.) E2. The top of the bottrxn floor (inducing basement a endosue) of the bulking is ft(m) _in.(an) ❑ above or El below (check one) the highest adjacent gade. (Use natural Bade, ii available). E3. Fa Building Diagams 6-8 with openings (see page 7), the next higher floor a elevated floc (elevation b) of the bulking is _ ft(m) _in.(am) above the highest adjacent gade. Complete items C3.h and C3.i on front of form. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the carrmwnity's floodplain management ordnance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this uifuniation in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTiFICA11ON The properly owner or owner's authorized restive who completes Sections A, B, C (Items C3.h and C3.i ony), and E fa Zone A (without a FEMAssued a carrnuniy- ued BFE) a Zone A0 must sign here. The statements in Sections A B, C, and E are correct to the best of my knoMedge. PROPERTY OWNERS 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 wtio is authorized by law a ordnance to administer the cormmunity's fioodplain management orccnance can carplete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sigi below. 01. ❑ The information in Section C was taken farm other documentation that has been signed and embossed bi a lid surveys, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) 02. ❑ A community official completed Section E fa a bulking located in Zone A (without a FEMMssued or community-issued BFE) or Zone A0. G3. ❑ The following information (Items G4-G9) is provided fa community ffoodplain management purposes. G4. PERMIT NUMBER (6. DATE PERMIT ISSUED GS. DATE CERTIFICATE OF COMPIIANCE/OCCUPANCY ISSUED G7. This permit has been issued fa-:0 New Construction ❑ Substantial Improvement 38. Elevation of as-built lowest floor (inducing basement) of the building is: G9. BFE or (m Zone AO) depth of flooring at the bulking site is: _ft(m) - _ f (m) Datum: Datxan: LOCAL OFFICIAL'S NAME COMMUNITY NAME SIGNATURE COMMENTS TITLE TELEPHONE DATE ❑ Check here if attachments OWNER RECONSTRUCTION / IMPROVEMENT AFFIDAVIT Name of Company etches R09,441 5e vfc Telephone Contractor Address Z5-S 4 uR I G A &ivc . -31-co riu jDAc t 44, 313cZ Name of Property Owner e-tAl Location of Property Li LA)t rrC 0A-a4 4. C l yge-e" 1 se.a+ua) 44. Z/32-i:1 I hereby attest to the fact that the attached itemized list of the Estimated Cost of Reconstruction and /or Improvements are all of the repairs and /or reconstruction and /or improvements proposed on the subject building for the attached Building Permit Application included with the estimate. Listed below are the date(s) and details of the last occurrence(s) of any repairs and /or reconstruction and /or additions and /or remodeling at this property: I understand that I am subject to enforcement action and /or penalties and /or fines if inspection of the property reveals repairs and /or reconstruction and /or improvements not included on the attached list of the Estimated Cost of Reconstruction and /or Improvements as well as the Building Permit Application as well as the list of the last occurrence(s) of any repairs and /or reconstruction and /or additions and /or remodeling. I understand that any Building Permit issued by the City of Tybee Island pursuant to this Affidavit does not authorize the repair and /or reconstruction and /or improvement and /or maintenance of any illegal additions, fences, sheds, or non - conforming uses or structures on the subject property. Total Labor & Materials $ '/! 6 00, Overhead & Profit $ Total Cost $ /, 6 Q(?,"G" STATE OF GEORGIA COUNTY OF CHATHAM Before me this day personally appeared 5 who, by his /her signature below, states that the information provided on this Affidavit is correct and that he /she has read, understands, and agrees to comply with all the aforementioned conditions. er's Signatu Sworn to and subscribed before me this Sigture of Notary Public My Commission expires f //./S/ 2 day of Pe ,20 . CONTRACTOR RECONSTRUCTION / IMPROVEMENT AFFIDAVIT Name of Company R I GIB R eos SCLA ( Telephone q 1 Z - 0 S 2 O Contractor Address 2 S S AU e- l 6-Pt 8 I v J .7Loonn (A) G- rJ 2 L- G-A 313o2. Name of Property Owner J b HA) PING I E 14 i t s Location of Property Li 1A/N ■ 1t Oat Lpw ) 71 1SEL 6.-P\ 31328 I hereby attest to the fact that I, or a member of my staff, inspected the above mentioned property and produced the attached itemized list of the Estimated Cost of Reconstruction and /or Improvements. Further, all of the repairs and /or reconstruction and /or improvements proposed on the subject building for the attached Building Permit Application are included in this estimate. I understand that I am subject to enforcement action and /or penalties and /or fines if inspection of the property reveals repairs and /or reconstruction and /or improvements not included on the attached list of the Estimated Cost of Reconstruction and /or Improvements as well as the Building Permit Application. I understand that any Building Permit issued by the City of Tybee Island pursuant to this Affidavit does not authorize the repair and /or reconstruction and /or improvement and /or maintenance of any illegal additions, fences, sheds, or non - conforming uses or structures on the subject property. Total Labor & Materials Overhead & Profit Total Cost $ �goo , 00 STATE OF GEORGIA COUNTY OF CHATHAM Before me this day personally appeared A"---A l 6/1/ C S 76 f who, by his /her signature below, states that the information provided on this Affidavit is correct and that he /she has read, understands, and agrees to comply with all the aforementioned conditions. Contractor's Signature Sworn to.and subscribed before me this I day of / `� ()I/4- 4 , 20 1 1 A. 1: :: ,:,.<N.1N :x-:, 7.:c,:1/4\- '_8i' 1 EXPIRES "•.Z : Y :GEORGE' % : AUG. 30, 2014 Signature of Nota Public My Commission expires Chatham County Board of Assessors: 2nl 1 Property Record Card 4- 0019- 04 -01? Page 1 of 2011 Chatham County Board of Assessors Property Record Card APPRAISER tlwhitfi LOT B SUB OF LOTS 6 & 7 HORSE PEN HAMMOCK FORT WD SMB 31S 45 LAST INSP 11/27/2006 APPR ZONE 000008 SALES BOOK / INS VI QU RSN PRICE PAGE 22 Aug 330U 0732 WD I U UN 635,000 2007 GRANTOR:COASTAL BANK GRANTEE:BARROW J RICHARD 01 May 325J 0672 NA I U UD 901,731 2007 GRANTOR:TAYLOR JIM L GRANTEE:COASTAL BANK 04 Feb 283G 0023 WD V Q QX 450,000 2005 GRANTOR:SHARPE WYMAN H GRANTEE:TAYLOR JIM L 26 Oct 278C 247 WD V U UX 581,300 2004 GRANTOR:KIETZMAN LOUIS W GRANTEE: SHARPE WYMAN H 09 Apr 272C 0098 WD V Q QX 1,000,000 2004 GRANTOR:HOGAN KAREN GRANTEE:KIETZMAN LOUIS W PERMITS TYPE DATE AMOUNT 050208 NC 13 Mar 2006 Insp 200,000 050208 CO 14 Feb 2006 Issued 050208 CO 20 Jan 2006 Issued COMMENTS: 12 Jun 2008 12 Jun 2008 06 Jun 2007 01 Mar 2005 2005 NEW PIN; SPLIT OUT OF ADD CHG PER LTR 06/12/08 DLB 2008 DIMENSION CHG PER SMB 31S 45 6/5/07 PL 4- 19 -4 -2 3/1/05 NJV EXTRA FEATURES ID# BLDG # SYSTEM DESC 141684 86837 WOOD DECK VG 141685 86837 Vg Cpt Flat/Shed Rf 141686 86837 Solid Wall /Slab VG LAND ID# 111625 111626 USE DESC SINGLE FAMILY RES SINGLE FAMILY RES 4- 0019- 04 -01; 4 WHITE OAK LN TYBEE ISLANE BARROW J RICHARD CAMA ASMT PO BOX 2826 154,700 189,500 LAND 2 TYBEE ISLAND GA 31328 211,200 188,500 BLDG 1 21,100 OBXF 3 387,000 378,000 MORATORIUi1 .'9 h ,;,,::w�:, 18 �'' i [Click for larger picture] CODES PROPERTY 0006 RESIDENTIAL USE UTA 0004 Tybee Island NBHD 020222.00 T222 TYBEE HORSE PEN EXEMPTIONS HISTORY '2011 '2010 2009 2008 2007 2006 2005 DIM 1 DIM 2 UNITS QL UNIT PRICE RCN AYB EYB DT ECON 0 0 172.00 V 15.20 2,614 2006 2006 2R 0 0 946.00 V 13.15 12,440 2006 2006 6R 0 0 182.00 V 38.30 6,971 2006 2006 6R LAND 189,500 189,500 189,500 292,000 235,000 264,500 149,000 IMPR 188,500 188,500 188,500 190,000 190,000 131,500 TOTAL 378,000 378,000 378,000 482,000 425,000 396,000 149,000 FUNC SP SP% RCNLD 2,222 12,067 6,762 MAV MAV Over Cams Cams CamE Came MKT VALUE 2,200 12,100 6,800 FRONT DEPTH UNITS / TYPE PRICE ZONING LCTN TOPO OTHER ADJ1 ADJ2 ADJ3 ADJ4 MKT VALUE 0 0 4,500.00 -SF 62.00 R2 147900 0 0 823.00 -SF 62.00 R2 SZ -75 6800 http: // boa. chathamcounty. org/ DesktopModules/ ChathamCounty/ BoardofAssessors /PropertyRecordCard. asp... 12/5/20 Chatham County Board of Assessors: 2n 1 Property Record Card 4-0019-04-011 Page 2 of 2011 Chatham County Board of Assessors 4- 0019- 04 -01: Property Record Card 4 WHITE OAK LN TYBEE ISLANE BUILDING SECTION CONSTRUCTION TYPE RCN AYB EYB DEP TYPE PHYS ECON FUNC OBSV / % TOTAL DEP % RCNLD U.FACTOR MKT VAL 86837 -1 Residential 217,722 2006 2006 MS 3.00 0.00 0.00 0.00 3.00 211,190 211,200 14' 11' 13' 13' ■ MVP Solid Pall Porch ■ a - -Ease I 3ng Area 364 II UPI I a rport ■Mit Dow LL -ing Area K a' ogsN 17 Y pf n Area I Deck en Aida ■ I 10 9114 ■ \11mD Slab Porch kith R,r,81ah Porch .it + ybfp,ek 9' 7' ■WOD Wall Deck Wood Deck • ■91f1 40 16 Slab Porch wkh Roof 85 [Click for larger picture] SECTION TYPE 1 - Main AREA 2006 TYPE 1 - Single- family Residence FRAME 1 - Stud Frame STYLE 2 - Two Story QUALITY 5.00 CONDITION 3.00 # UNITS 0 # OF BEDS / BATHS 3 / 3.00 COMPONENTS R1 108 Frame, Siding, Wood R2 214 Metal, Preformed R3 352 Heat Pump R4 402 Automatic Floor Cover Allowance R6 601 Plumbing Fixtures ( #) R6 602 Plumbing Rough -ins ( #) R6 622 Raised Subfloor (% or SF) R6 642 Single 2 -Story Fireplace ( #) R11 904 Slab Porch (SF) with Roof R11 904 Slab Porch (SF) with Roof R11 904 Slab Porch (SF) with Roof Units % QUAL 100.00 100.00 100.00 14.00 1.00 1.00 40.00 85.00 85.00 100.00 http: //boa. chathamcounty. org/ DesktopModules/ ChathamCounty/ BoardofAssessors /PropertyRecordCard. asp... 12/5/20 Clear Project Management - iew) FuQ File Edit Options Functions Help Project # Property 050208 4 Net Project # I 'WHITE OAK LANE Description Issued to NEW RESIDENTIAL BLDG [TAYLOR, JIM General) Segments 1 Financial] Property Info 1 Information 1 Comments 1 History 1 Footprint 1 Conditions 1 Description 1 Project Mailing Address Attention Address r General Contractor Project Type Dwelling Type Square Footage Units P O BOX 14124 SAVANNAH, GA 31418 1— Edit This Record CONST Private 1831 CONSTRUCTION Project Details Applied Date Issued Date Expires Date Completion Date B alance Pending Activity Securities 5/10/2005 5/10/21i. 5/11/ 2/14/2006 0.00 0.00 0.00 f�/2- ev, Car. e`� Co r<vex+ garage cp ac e. 40 s4-9race. (w orksLt.op) gays L412.2q31 Wank 0(d1, � ( aS � ate. Pri'ato-k4;°) P