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CITY OF TYBEE ISLAND
BUILDING PERMIT
A 25 -FOOT WIDE AREA OF ROCK IS ALLOWED AT
THE PROPERTY LINE. ALL OTHER ROCK MUST
NOT TOUCH THE PROPERTY LINE.
DATE ISSUED: 07-1-2013 PERMIT #: 130415
WORK DESCRIPTION DRIVEWAY
WORK LOCATION 173 LEWIS AVE
OWNER NAME JEFFTON SLAUGHTER
ADDRESS 173 LEWIS AVE
CITY, ST, ZIP TYBEE ISLAND GA 31328
PHONE NUMBER
CONTRACTOR NAME JEFFTON SLAUGHTER
ADDRESS 173 LEWIS AVE
CITY STATE ZIP TYBEE ISLAND GA 31328
FLOOD ZONE
BUILDING VALUATION
SQUARE FOOTAGE
OCCUPANCY TYPE P
TOTAL FEES CHARGED $ 352.00
PROPERTY IDENTIFICATION # PIN #4-0016-03-002
PROJECT VALUATION $1,280.00
Work without a permit — double fees plus penalty TOTAL BALANCE DUE: $ 352.00
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 monthsgf4e date of issuance.
Signature of Building Inspector or Authorized Agent:
P. O. Box 2749 - 403 Butler Avenue,gybee Island, Georgia 31328
(912) 786-4573 - FAX (9I2) 786-9539
www.cityoftybcc.org
Property Address:
Leuj'd s Ay
City of Tybee Island, Georgia
912-472-5033 or 912-472-5031 - Fax 912-786-9539
APPLICATION FOR BUILDING PERMIT
-Qm/' - 9
-00,7—
Name
ppm
Single Family
❑ Duplex
❑ Multi -Family
❑ Commercial
Details of Project:
if/ V (Check all that apply)
❑
D iscove ry/Tea rout
❑ Footprint Changes —
units new_ square feet
units heated/cooled
emolition of Structure
❑ Other
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V
Estimated Cost of Construction: $ (materials + labor + profit/overhead)
If applicable, attach a copy of the certified elevation certificate and/or survey of the property. Depending upon
the scope of the work, two sets of construction drawings and/or a site plan may be required.
JN
Year Built: 14P52-�
Listed on National Historic Register or located within a National Historic District? Y / N
* Buildings older than 50 years may be eligible to be listed on the State / National Register. With this designation, you
may be eligible to take advantage of various tax incentive programs while preserving the heritage of Tybee Island.
*Also see the Tybee Island Land Development Code Article 14: Historic Preservation
During construction:
On-site restroom facilities will be provided through . Construction debris will be disposed
by by means of I understand that I must comply with zoning, flood
damage control building fire shore protection and wetland ordinances FEMA regulations and all applicable codes and
regulations. I realize that I must ensure the adequacy of drainage of this property so that surrounding property is in no way
adversely affected as required by Article 16, Stormwater Management. I accept responsibility for any corrective action that
may be necessary to restore drainage impaired by this rmitted con uction.
Date. Signature of Applicant. FEES
Printed Name Permit
�7p Inspections
_Note: A permit normally takes 7 to 10 days to process 4/ Cap Cost Rec
Water Tap
Approvals: Sionalqre ate Sewer Stub
Planning & Zoning Manager & ri f Eng. Fees
Building Official �/�id to Const. O
Water/Sewer
Storm/Drainage
City Manager � SO
(5�-G�J 'Prod cr I►',.�. TOTAL
Name Mailing Address
Telephone
Owner
✓'
f % (,Q
H�ome�
Cell: d -00
Architect or
Engineer
Contractor
CVsj �,��
L I /
Off tce:
Cell:
Single Family
❑ Duplex
❑ Multi -Family
❑ Commercial
Details of Project:
if/ V (Check all that apply)
❑
D iscove ry/Tea rout
❑ Footprint Changes —
units new_ square feet
units heated/cooled
emolition of Structure
❑ Other
2S-�
�� � Wed¢. QrceL o.F r94is GZI o,-,scd q+ pr -apo -L'., i'`W.
A0 oUxtr rocK mo si, nom 4,o 'U
V
Estimated Cost of Construction: $ (materials + labor + profit/overhead)
If applicable, attach a copy of the certified elevation certificate and/or survey of the property. Depending upon
the scope of the work, two sets of construction drawings and/or a site plan may be required.
JN
Year Built: 14P52-�
Listed on National Historic Register or located within a National Historic District? Y / N
* Buildings older than 50 years may be eligible to be listed on the State / National Register. With this designation, you
may be eligible to take advantage of various tax incentive programs while preserving the heritage of Tybee Island.
*Also see the Tybee Island Land Development Code Article 14: Historic Preservation
During construction:
On-site restroom facilities will be provided through . Construction debris will be disposed
by by means of I understand that I must comply with zoning, flood
damage control building fire shore protection and wetland ordinances FEMA regulations and all applicable codes and
regulations. I realize that I must ensure the adequacy of drainage of this property so that surrounding property is in no way
adversely affected as required by Article 16, Stormwater Management. I accept responsibility for any corrective action that
may be necessary to restore drainage impaired by this rmitted con uction.
Date. Signature of Applicant. FEES
Printed Name Permit
�7p Inspections
_Note: A permit normally takes 7 to 10 days to process 4/ Cap Cost Rec
Water Tap
Approvals: Sionalqre ate Sewer Stub
Planning & Zoning Manager & ri f Eng. Fees
Building Official �/�id to Const. O
Water/Sewer
Storm/Drainage
City Manager � SO
(5�-G�J 'Prod cr I►',.�. TOTAL
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