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CITY OF TYBEE ISLAND
BUILDING PERMIT
DATE ISSUED: 10 -7 -2008 PERMIT #: 080427
WORK DESCRIPTION DEMOLITION OF HOUSE
WORK LOCATION 160 LEWIS AVE
OWNER NAME MICHAEL ROACH
ADDRESS PO BOX 337
CITY, ST, ZIP TYBEE ISLAND GA 31328 -0337
PHONE NUMBER
CONTRACTOR NAME MICHAEL ROACH
ADDRESS PO BOX 337
CITY STATE ZIP TYBEE ISLAND GA 31328 -0337
FLOOD ZONE
BUILDING VALUATION
SQUARE FOOTAGE
OCCUPANCY TYPE P
TOTAL FEES CHARGED $ 200.00
PROPERTY IDENTIFICATION #
PROJECT VALUATION $2,000.00
TOTAL BALANCE DUE: $ 200.00
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: ______c j. j
P. 0. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328
(912) 786 -4573 - FAX (912) 786 -9539
www.cityoftybee.org
CITY OF TYBEE ISLAND, GEORGIA
APPLICATION FOR BUILDING PERMIT
vaTi
Location: / D 1 V ( 1 PIN #
NAME / ADDRESS TELEPHONE
Owner t' L 1l I g �r e r,6 c) / lC c f C L /er _3 6 X (4 (46/
Architect
or Engineer 0/3 ox 33 7, % 1j j34 _ ez
Building
Contractor
(Check all that apply)
❑ Repair El Residential ❑ Footprint Changes
❑ Renovation ❑ Single Family El Discovery
El Minor Addition ❑ Duplex 'Demolition
❑ Substantial Addition ❑ Multi - Family
❑ Other ❑ Commercial
Details of Project: 0 Ouv-q A-G f S��vc. f -t.)
Estimated Cost of Construction: $ , 0 C )
Instruction Type / (Enter appropriate number)
(1) Wood Frame (4) Masonry (6) Other (please specify)
(2) ood & Mas (5) Steel & Masonry
(3) : 'ck Veneer
Propos a use:
Remark /
ATTACH • OPY OF THE CERTIFIED ELEVATION SURVEY OF LOT and complete the
following ' •'•irmation based on the construction drawings and site plan:
# Units # Bedrooms # Bathrooms
Lot Are \ Living space (total sq. ft.)
# Off- eet parkiik spaces
Trees ocated & lis&d on site plan
Acc s:
Dri eway (.) With culvert? With swale?
S backs: Front Rear Sides (L) (R)
Stories Hei t Vertical distance measured from the average adjacent
grade of the building to the xtreme high point of the building, exclusive of chimneys, heating
units, ventilation ducts, air ditioning units, elevators, and similar appurtances.
During construction:
On -site restroom facilities will be provided through 6 (Jh( •
On -site waste and debris containers will be provided by A-L.
Construction debris will be disposed by 4-6 C by means of v`m( , s
- -
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: /0 '--6 - 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 NFIP Flood Zone
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 finding(s)
Access to building site
Distance to water main tap site
Distance to sewer stub site
Water meter size
Storm drainage
Approvals: ' /� Signature Date FEES
Zoning Administrator / :�/ /� /1 Permit Z69. e5---
Code Enforcement Officer /,,1/,lC / �,-� /Q- (o Inspections
Water /Sewer Q Water Tap
Storm/Drainage Sewer Stub
Inspections Aid to Const.
City Manager
TOTAL -7))9,9
OISFGOF
ABSOUNCES
r %try
GEORGIA
Permit Acknowledeement of
Asbestos/Environmental Notification to Georgia EPD for
Proiects 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.
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Undersigned Date
Printed Name
Office Use Only:
Project Address:
Permit Number:
10/06/2008 14:05 9127866538 TYBEE ISL HIST SOC PAGE 01
• • • f 6, 208 ^ ' RECEIVE D
Ms. ■ianne R. Otto
A. istrative Assistant
City ff Tybee Island
Buil ng and Zoning Department
P.O.; ;dx2749
I , Island, Georgia 31328
Des , Dianne,
I ha Made a site visit to #loo Jones Avenue for which an application for
dem ition has been requested. The house in question is not architecturally nor
hist. r ally significant. Therefore please proceed with the request for demolition
as • n as it is desired to do so.
Sine
Cull. Chambers
Ex • i` do Historic Preservation Advisor
Ty • = Wand Historic Review Commission
TX Result Report P 1
10/06/2008 11:42
Serial No. CM35228060004
TC: 1244
Destination 1 Start Time 1 Time 1 Prints 1 Result' Note
7866538 1 - 06 11:41 100:00:37 1001/001 1 OK 11 1
Note BHD: Double- SidedaBindifl9 D irection1 T Specia7 ina l F F FCOD E : F -code. RTX: Re -TX.
RLYAX: : ReIla ternet MBX: Fax on Cfidential. BUL: Bulletin. SIP: SIP Fax, IPADR: IP Address Fax.
I -Fn
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 Fu11:Memory Full,
LOUR:Receiving length Over, POWER:Receiving page Over, FIL:File Error,
DC:Decode Error, MDN:MDN Response Error, DSN:DSN Response Error.
4 o City of Tybee Island
` BUILDING ANTE, ZONING
P_O_ Boz 2749 — 403 Butler Avcaue, a`ybee Island, Georgia 31328 -2749
(912) 786 -4573 — FAX (912) 786 -9539
-
Y www_cityoitybee _ org
FAX TRANSMITTAL SHEET
Date. 1 c- - (_-. `fig'
Number ofPa In cluding Cover Sheet: 1
To: Cullen Chambers
Company Name: Tybee Island Historic Review Commission
Fox Number: 786 -6538
From: Dianne K. Otto
Title: Administrative Assistant
Phone Number: 786 -4573 extension 114
Fax Number: 786 -9539
NOTICE QF A P•i ,,ICATION FOR D
Date of Application 1 I ---- N - ( ->
Name of Applicant M g.a_( � ;--. n --_--
Phone Number �• a 1 -. r" 1
- - .cation of Structure 1 (..". n L_, , , , _ e ,A‘tQ, _