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07-0027 Busz
i3. �K 16 �{ CITY OF TYBEE ISLAND BUILDING PERMIT DATE ISSUED: 01-22-2007 PERMIT#: 070027 WORK DESCRIPTION: NEW RESIDENTIAL BLDG-DUPLEX WORK LOCATION: 59 4.-Sg p CAPTAIN'S VIEW OWNER NAME RICHARD BUSZ ADDRESS 667 US 131 CITY,ST,ZIP BOYNE FALLS MI 49713 CONTRACTOR NAME - RICHARD BUSZ ADDRESS 667 US 131 CITY STATE ZIP BOYNE FALLS MI 49713 FLOOD ZONE BUILDING VALUATION SQUARE FOOTAGE 5582 OCCUPANCY TYPE P TOTAL FEE'S CHARGED $12,049.00 PROPERTY IDENTIFICATION# PROJECT VALUATION $750,000.00 TOTAL BALANCE DUE: $12,049.00 It is understood that if this permit is granted the builder will at all tines 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. 0...A.,.- D6 Signature of Building Inspector or Authorized Agent: P.0.Box 2749-403 Butler Avenue,Tybee Island,Georgia 31328 (912)786-4573-FAX(912)786-5737 www.cityoftybee.org �svf.. 4 r \ Ni tQ'q�. 1hDM , CITY OF TYBEE ISLAND CERTIFICATE OF OCCUPANCY DATE COMPLETED: 12/18/07 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#: 070027 PROPOSED USE: NEW RESIDENTIAL BLDG-DUPLEX OCCUPANCY TYPE: P CONTACT NAME RICHARD BUSZ CONTACT ADDRESS 667 US 131 CONTACT CITY STATE ZIP BOYNE FALLS MI 49713 PROPERTY ADDRESS 57 CAPTAIN'S VIEW c... .APPROVED BY: P. O. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328 (912) 786-4573 - FAX (912) 786-5737 www.cityoftybee.org • Richard Busz • 57 Captains View Tybee Island,GA 31328 • • May 19,2008 Chuck: I am attempting to get a"hurricane shutter credit"that was promised if I provide proof of having impact resistant glass doors and windows. The insurance company(Lloyd's)or their correspondent (SEACOAST BROKERS)informed my agent Jovanna Dukes of the Bush Ins Agency to have me obtain a mitigation form signed by a state licensed inspector for the impact resistant glass. I am sending copies of the receipts for the doors and windows to you. Can you provide the requested proof of impact resistant glass? If you do not have a mitigation form,please send a convincing letter. I have enclosed an addressed envelope. I am sorry to take your valuable time,but don't know any other way. I will inform you of the amount of discount/credit when done. Sincerely, Richard Busz (231-330 4111) MAYOR, r�r CITY MANAGER Jason Buelterman Diane Schleicher CITY COUNCIL CITY CLERK Wanda Doyle ; `i Vivian Woods Charlie R.Brewer 410 Barry Brown CITY ATTORNEY Eddie Crone Edward M.Hughes Dick Smith •• o�cif Paul Wolff CITY OF TYBEE ISLAND Date: June 3, 2008 Re: Richard Busz, 57 & 59 Captain's View Tybee Island, Ga. 31328 - Window information (Use of Impact Glass) To Whom It My Concern: This letter is to confirm that the windows used and installed by Mr. Busz for the construction at 57 &59 Captain's View meet the current requirements per the wind code. Our records show that inspections were called for and passed. The windows used met or exceeded the"Design Pressure Rating" of 45 or higher for the negative forces. And the means of protection on the windows installed meet the"Impact Rating" for the positive forces for our wind zones. If you should need any further information please feel free to contact me at (912) 786-4573x104 Sincerely Chuck Bargeron City Marshal Building and Zoning Tybee Island, Ga. 31328 P.O.Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (866)786-4573—FAX(866)786-5737 www.cityoftybee.org Jason BuRelterman ist CITY Diane Schlei herR CITY COUNCIL CLERK OF COUNCII Wanda Doyle,Mayor Pro Tern t -.•_,. Vivian Woods Charlie R.Brewer Barry Brown CITY ATTORNEY Eddie Crone Edward M.Hughes Dick Smith o i �g Paul Wolff pg1 CITY OF TYBEE ISLAND FAX TRANSMITTAL SHEET Date:-J tv<e_ 31 ZO c 8 Number of Pages Including Cover Sheet: L To: —JO vc: r\ a Company Name: R. a , s1,\ 1-- Co v p•a rn ci Fax Number: t Z) rift- 3 5&' 3D..CP 3 From: CA u.e k �2.,� ,�r o Title: L44.1 yn a r s I. Phone Number: e 12 ) 1800 4 513 x 1 O`f Comments: ** * ** P 0.Box 2749-403 Butler Avenue.Tybee island,Georgia 3 1328-2749 i (912)786.4573•FAX(912)786-5737 !d►iu www.cityoftybee.org O *************** —COMM. JRNAL— ******************* DATE JUN-03-20. **** TIME 1445 ******** MODE = MEMORY TRANSMISSION START=JUN-03 14 40 END=JUN-03 14 45 FILE NO.=365 STN COMM. ONE—TOUCH/ STATION NAME/EMAIL ADDRESS/TELEPHONE NO. PAGES DURATION NO. ABBR NO. 001 OK s 3563263 002/002 00:00:31 —CITY OF TYBEE ISL. — ************************************ —CITY OF TYBEE — ***** — 912 786 9539— ********* MAYOR Jason Buetterman 4/.0 CITY MANAGER CITY COUNCIL I Diane Schleicher L. Wanda Doyle,Mayor Pro Tern CLERK OF COUNGII Charlie R.Brewer Vivian Woods Eddie Crone CITY ATTORNEY Dick Smith M.Hughes Paul Wolff � +���1yy� CITY OF TYBEE ISLAND FAX TRANSMITTAL SHEET Date: 3 ©08 Number of Pages Including Cover Sheet: To: -...Jo V rr y- Company Name: R Y)1. Bus • C o rn p a v\(3 Fax Number: et. z) " - 35/2—S.2.43 From: CkL. t.4c a,ry. re r. C'i ' t �2 v" k Title: "� h.�. Phone Number: (1 LL) --4 5 13 . \ Comments: P 0.Box 2749,403 Bwkr A''st c.Tyb a Island • Georgia 3(328.27419 (912)786-473-FAX(9 t2)780.3737 WWW.cltyo*ybrc o.g �� I I E ' d v, o uJcse; "Rtatzwa!t,F atilt it with Gase" s I9 2925 i o-OC (843)7 84 200E or a c_Y, M1 x�i2 �.?i2 7925 347CO 'Y (f 89w:1)87s 81 4.2F00- . (912)748.7376 (91 2)8324068 r ":_- -1:'''''':N!'! _. ''"f""c''""*'''''"""' - _.-._... --.... 8818,C;r' _ _ - �-- . _ ~ 07:33:43 105/22 0 711468 i ,.:,1;:.w'.� ... 07;3343 105122/07 76468 I DUS001 AB93226 ** INVOICE ** BUS001 A893226 ** INVOICE ** S RUE CONSTRUCTION S 57 CAPTAINS VIEW BUS) CONSTRUCTION s 57 CAPTAINS VIER c LLC ' LIGHTHOUSE POINT ; L LLC LIGHTHOUSE POINT D 57 CAPTAINS VIED P TYSEE i D 57 CAPTAINS VIEW TYBEE T TYDEE ISLAND: CA. 31328 231-330-4111 T TYDEE ISLANIN► CA. 31328 231-330-4111 T 0 0 1 0 0 TAX JURIEOECTiOvS YC✓L'EsC't1MOA TAX EXEMPT TAX JU?ISCICTh3A N0 9SORPTION TAX CACAPT €231)330-4i11 0025 Chatham County ? 1231)330.4111 0025 Chatham County IQC. DATE On"f 5RCO DATE P,RIPP SHIP VIA d0E10. GJST ORDER NO, KS CLERI( Fa t,iS copy ohs l . ICC. DAYS COM WE 8455E0 SAP V A JOSA0, OlST.05895150, 519 01555 tis�l!5 COPY Pk ' 0103/27/0705/22/07 29 30NET 10TH 0142 I 0103/27/0705/22/07 29 30NEET 10TH 0101 1 a. .C`... . ,;PPED i. E < t-iiPT w P U AMOUNT T m1 °n.o M-PEE.' 0SSCMPI0F )PRICE A O NON-INV Yf .• 10613.85 127.70 EA I T16/GARY/SCOTT f 28.6 FULLVIEW IMPACT - 1-'7711468 RAID SYSTEM s I is' 11W FIBER CLASSIC • NON-INV 1.00 L IS 177 .04 1774.04 1 NI's S PATIO DOOR SYSTEMS • EA i --- - IN ACT RATES DP47 ' ' "'nM'rN-INV i 1.00 Ring 177 .04 774.04 1 I I1 Ti POINT LOCKS I ' EA I F I I IKON SATIN NICIELI I k 64 6 F1 L1 VI ,N JAMB 'USED f I SA IN NICKEL }NIBS PATIO IMPACT RATED SYSTEM j I I I .SAVER .IAMBS 6 9/16 NON-INV 1.00 ` IS LF 29 .32 925.32 I NON B K RICXMOLD CAS EA 1 ' INkCKEL TRUDEF SE SILLI • NON-INV 1.00 IS FR Z92 .32 25.32 50 FULLVIEW JANE RINGED EA I > PA 11) IMPACT RATED -TRU FIBER CLASSIC N -INV 1.00 R IS FR 292(.32 925.32 ENT DOOR UNIT EA I • 30i8 FC 21-1C 14/19800 1 NOW-INV t 1.00 IS LF 292 .32 925.32 T- C TRAi1S8M ° EA I kk IN CKEL CANING] 1 34 8 FULLVEIV IMPACT I 6 1016 FRANESAVER JANBS RA ED SYSTEM TRU-DEFENSE ; 1 NUN-INV 2.00 L:-IS 1060.85 127.70 1 NI KEL SILL NO BRICK NOLO i EA 1 FI £RCLA IC FULLVIEU r { i f F i I CONTINUED i HICUNTIMUED i SALES AMOUNT 1 SALES TAXI SHtruh4G 050 i f COOS!QEPOSIT CASH C 0E SALES N !S ES X°SHIPPOC Na. 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"rest A"_fer-..h on..ol r All bills are payable Dn the 10th of the month following billing date and are past due.after 30 days.Past due accounts are subject toe FINANCE CHARGE of ills%PER MONTH on the past due unpaid balance which is an ANNUAL PERCENTAGE OF 15%),RETURNED GOODS:STOCK ITEMS IN ORIGINAL UNITS OR FULL PACKAGES WILL BE ACCEPTED FOR CREDIT OR EXCHANGE WHEN RETURNED IN GOOD CONDITION WITHIN 30 DAYS OF PURCHASE,AND ACCOMPANIED BY AN ORIGINAL SALESTICKET. Type or Transaction Store s r SOLD • TO; 2•Y* e+ ;r i is g M.. .- - - FiZtlis I 11 • Customer Code. Transaction Date Transaction No. Time f Order Date Delivery Date g Reference Number P.O. u Salesperson Line Item Cade tm.chasns - OD-ShiPr� ; Description ' Units Price Unit E.tension Location F- Ai ytiif 't N M-77: A ... ..?.. 1, L _ y. es.. .«Y1 __z v,y -.. rr'�'+.yl .....« .j -S1i - I . w tT I(2 J•ft _ !!/77— �:. _ .. ..A -..0 is -.+ 1 :;' ;1r - h I _ n; is s TUNER f#34i`` ` Sub-Total Tax Rate Tax Tots~ PLEASE EXAMINE GOODS BEFORE ACCEPTING. AFTER GOODS ARE ACCEPTED,OUR RESPONSIBILITY CEASES. ERRORS OR DAMAGE MUST BE NOTED AND CORRECTED ON RECEIPT OF GOODS DELIVERED PRICES BASED ON TAILBOARD DELIVERY. REC'D BY DATE SAT,FRI. LOADEDACHECKEDBY HaPONJOEt DYES Ow ..- . DELIVERED BY DATE DEUVERED ' 0 DELIVER 0 PICK-UP - 900 Spring Street . 0 8600 Moeller Drive Petoskey,MI 49770 Harbor Springs,MI 49740 231-347-2501 , i 3689 Oici 27 South 231-348-2990 . 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Salesperson ,‘& -,,-, ,,-•:.7.7: I Vine item Code on.tkdetell Q .Shipped Description Units Price Unit ' Extension Location Ti 2-C3" - "3,-i;.,- ' 417:3: : 2 *--:. , 7...77, 7'..' l'.7 7..77.---'''''' 2'• .; -1 r'-'-' '-:':-_.--'-': '''' ' 77; . : _.lf-,,:77,'151 J I -:31 =.---1,-1,f 2.: ,_ h;.-.,:,..7 3.- :, `.--i7;,-' .-.4' •:-...,-4Tel .:,..ii14.-..-- :'':. :.-Kr iik.i, im.2-‘ I . . ......., . .. .--... 4 •-: L--:,:: ' -,4.1.',:..--;:7. . -:-..;.2-'::, -. ', I :,, :, . , . - 4 ia r,:,T . A ,._ Ti3f:=7-. -tr-illf.; 36.40 %iM 3; Y 7-77,- 2S E.'S t:T,P77 7-Z7:70. !•747U: , .,',.7i77.Vat .. ac : r • fi',C;i• 1 •:•.•; -! 1 HP .;,*0.=, i7k7=7 !f/-",,!.,1, ;.::..,70T :!r#i"I:', i77._ 7'': :.:OM 7.7y;.5r,,i• ' :-..;;I:4 T -7.-- .7,. . . ' ,;_pp165',3 iltli NiLL .;;IT,-:,:::Tft - 7 - 7';4.24.12 7117X M: e:-? 7'1 37 : K.'.NI? f%WC 77-2.73': ',7,1,i.'st, ,i •••:,:k.. :;-? 1-•‘. ?:-..=',,"■.:::taf:?_ j'„.!,:,:1":7j.;;:. :::I'--::17.;- -.',J.,'N,i; : :2.0.7T''..7'- TA-f'. . c.-,_g3 i • ' i - 1:*;77:7 113.7:7777: 12-'747!_:'• "c.:,,,,:".7:7" Ef'-'7"I iii-C:',7 J. . , Sub-Total Tax Rate : Tax . Total . . PLEASE EXAMINE GOOD BEFORE ACCEPTING:AFTER • GOODS ARE ACCEPTED,OUR RESPONSIBILITY CEASES. . ERRORS OR DAMAGE MUST BE NOTED AND CORRECTED ON RECEIPT OF GOODS . . DELIVERED PRICES BASED ON TAILBOARD DELIVERY. REC'D BY DATE i 4 tFRIRI L t.. SAL • _ '.. LOADED&CHECKED BY ' HELP ON JOB I 0 ❑YES ❑No DELIVERED BY DATE DELIVERED . 0 DELIVER 0 PICK-UP - __ 900 Spring Street Moeller Drive Petoskey,Mt 49770 Harbor Springs,MI 49740 231-347-2501 0 8669 Old 27 South lord,lint 49735 231-348-2990 i Gay 989-732-FP52 WwWupr for �:, ",-'e All bills are payable on the 10th of the month fo'!o:rin3 bttr!�q`date and are past due after 3Ddays Past due accounts are subject to a FINANCE CHARGE of 1 to%PER MONTH on the past due unpaid balance fwhtch is an ANNUAL PERCENTAGE OF 18%).RETURNED GOODS:STOCK ITEMS iN ORiGiNAL UNITS OR FULL PACKAGES WILL BE ACCEPTED FOR CREDIT OR EXCHANGE WHEN RETURNED IN GOOD CONDITION WITHIN 30 DAYS OF PURCHASE,AND ACCOMPANIED BY AN ORIGINAL SALESTICKET. SOLD TO; m • ' Customer Code ` Transaction Date 3 s:n a�,oat No. : Time Order Date Delivery`Date 2,-',"'.;4 v` -ATi7 Reference Number P.O. Salesperson ' i `mot _ fie' 11,7.3; .,_ r 7'7 €iVt st r Line item Code Qn.cl£aDr Qtp.ShippeA Description Units Price Unit Extension Location -. rY f t. j.? miS i& • : g i°ps =t D-'7-''',.t g I 1 7 4 7 7 1 0 ,T..7 7,0 t.`fa c'rt„ r.7-.7.7 e,..6 _ g , 7 r i �. "i L..., r "-' 'i'# .s, ` 1::°-:7•'-',' ?£.i t i ILL tic,' _. L a % 4 - "2,lag - ">.f .,:i2.:+ri 2i;,$°+i - - . . - . • =9A a R • Sub-Total Tax Rate Tax T©ta. • . __ PLEASE EXAMINE GOODS BEFORE ACCEPTING. AFTER - Y GOODS ARE ACCEPTED,OUR RESPONSIBILITY CEASES. ERRORS OR DAMAGE MUST BE NOTED AND CORRECTED ON RECEIPT OF GOODS - DELIVERED PRICES BASED ON TAILBOARD DELIVERY. 17";71,4 3se 3 RECD BY DATE • FRI. SAT. LOADED CHECKED BY HELP ON,1Oe J ❑•0 - -- - DYES Dso �--�t DELIVERED BY DATE DELIVERED L__I DELIVER ❑PICKUP 900 Spring Street ELI Petoskey,Ml Street t' ❑ 8500 Moeller Drive 231-347-2501 n 3_ South Harbor Springs,MI 49740 C 49735 231-348-2990 989-732-8862 All bills are payable cm'' s— date and are past due after 30 days.Past due accounts are subject to a FINANCE CHARGE of 1112%PER MONTH on the past due unpaid balance r'r x g=,?,RETURNED GOODS:STOCK ITEMS IN ORIGINAL UNITS OR FULL PACKAGES WILL BE ACCEPTED FOR CREDIT OR EXCHANGE'NHS =. _ _12 w3., .)„..;ITHtN 30 DAYS OF PURCHASE,AND ACCOMPANIED BY AN ORIGINAL SALES TICKET, Type of Traasacfioe SOLD TO; ',, E - - Customer Code Transaction Date Transaction No. Time Order Date : Delivers Date .., . _ :• - -f _.;-:1 - few, Reference Number O. Salesperson i Line Item Code t Qe.theme Qn,Shipped Description Units Price Unit Extension Location 1 Sub-Total Tax Rate Tax 11-' . Ll PLEASE EXAMINE GOODS BEFORE ACCEPTING. AFTER GOODS ARE ACCEPTED,OUR RESPONSIBILITY CEASES. ERRORS OR DAMAGE MUST BE NOTED AND ° �L' `` CORRECTED ON RECEIPT OF GOODS DELIVERED PRICES BASED ON TAILBOARD DELIVERY. is RECD BY DATE 1 03- ;� m�i mss-'' O car- tii CITY OF TYBEE ISLAND CERTIFICATE OF OCCUPANCY DATE COMPLETED: 12/18/07 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#: 070027 PROPOSED USE: NEW RESIDENTIAL BLDG-DUPLEX OCCUPANCY TYPE: P CONTACT NAME RICHARD BUSZ CONTACT ADDRESS 667 US 131 CONTACT CITY STATE ZIP BOYNE FALLS MI 49713 PROPERTY ADDRESS 59 CAPTAIN'S VIEW APPROVED BY: `" P. O. Box 2749 -403 Butler Avenue, Tybee Island, Georgia 31328 (912) 786-4573 - FAX(912) 786-5737 www.cityoftybee.org '4444;„.L.00"' CITY OF TYBEE ISLAND BUILDING PERMIT DRAINAGE REVIEW FEE DATE ISSUED: 12/11/07 PERMIT#: 070027 WORK DESCRIPTION: NEW RESIDENTIAL BLDG-DUPLEX WORK LOCATION: 57&59 CAPTAIN'S VIEW OWNER NAME RICHARD BUSZ ADDRESS 667 US 131 CITY,ST,ZIP BOYNE FALLS MI 49713 PHONE NUMBER 231-330-4111 CONTRACTOR NAME RICHARD BUSZ ADDRESS 667 US 131 CITY STATE ZIP BOYNE FALLS MI 49713 FLOOD ZONE BUILDING VALUATION SQUARE FOOTAGE 5582 OCCUPANCY TYPE p TOTAL FEE'S CHARGED $12,161.50 PROPERTY IDENTIFICATION# PROJECT VALUATION $750,000.00 DRAINAGE REVIEW FEE TOTAL BALANCE DUE: $ 112.50 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. r Signature of Building Inspector or Authorized Agent: 411 _ A .a.d L 01 P.O.Box 2749-403 Butler Avenue,Tybee Island,Georgia 31328 (912)786-4573-FAX(912)786-5737 www.cityoftybee.org DAVIS ENGINEERING, INC. 636 Stephenson Avenue, Suite C Savannah, Georgia 31405 RECEIVED Tel. (912)355-7262 Fax(912) 352-7787 davisengincabellsouth.net INVOICE December 11,2007 Invoice#20700302 Diane Otto City of Tybee Island P.O. Box 2749 Tybee Island,GA 31328 Phone (912)786-4573 Fax: (912)786-9539 RE: 57 Captains View for Richard and Sandra Busz December 11, 2007 0.75 hours Site Review and concurrence of completed project. 0.75 hours @$150/hour= $112.50 Total Due This Invoice Based on my observations and experience and to the best of my knowledge and belief,this site development portion of this project meets the requirements of the City of Tybee Island Ordinances. Jo r122O- 52- I2o2 � 3'0� • o d (Li.a °Z.? 0-1-°°2:' • o —Brant-Iv, Robert C. Millikan GA Reg Prof Engr # 5717 GA Reg Prof Land Surveyor#1582 Level II GSWCC #0000033914 Tybee Island Special Trade Contractor#01378 P. 0. Box 2096 Tybee Island, GA 31328 (912) 786 - 4805 RECEIVED (772) 464-1010 Florida 12-u c,7 (912) 655-5744 cell 'Z/4/07 Drn 'toactc PAHQ 57 5? Co pia; 1//C r Air. ,s, E; hove ,'�� -(ha, 59c 5 T C cl i 30 B i wly C3 ; v on 7'Az dr-eq;viclie :5 Siet,14 elikalo5 W ;C' - 7LJ 1/100 v\ Q V1 wt c t,�J 1 1/-z7-06 `` pld ����► ��;�� �a� La/ 57 Ca �G; vl5 Ur-�. (Lc> 30 C' q c) 0 s Kc�tzJ �' l prope\r- q I() °1 111c(4) i5 y.deviti 4‘o z_t let 1 .‘1`-1/14 t?ucl S (/- i'j / JiCi Fi $‘ 114 C.173,\srirk:-‘14. No 71 CEyeirC:C6, t'ROFE$SIOKAL QT,C6A C\Akla.,01/0A, 6- 447.c. ' 4 . .•,,5/-•--- •:I;,', Inspection Report City of Tybee Isianti 403 Butler Ave. P=0. Box 2149 Tybee Island, GA 31328 Phone: (912) 786-4573 ext. 114 Fax: (912) 786-9539 Perot NOM - 0 02:D Date Requested r2 -i 3 -07 Owner's PI atne. --?-)LJ S 2- Date Needed -- Gen. Contrart-c.)r Subcontractor Contact Number ----D : k ( 3 I) 5 3 0 LocationS71 -fr_. 5 9_ .00,4 4-0'1 r\_5.-.0 V i eLAD Inspector e natp of inqpertion /,-- - /44 - 0 7 Type, r•I 1 nspe..ctio p ,--- e: L „0-1-- 1'o,-) c:f,IT gcce 6 6--7 A/C1121herS Pass 4 5 bA. 4 A ' Ci .5 / k tec, r fde . . (71-_s . 0_.\\..,c-,pie 0 . ,....,, v E 1 7 57 9- 5 9 1.0 , ?ortLit' e,Jo 4K- rig- iS I Flood (f(- -) i (:))/ ( HA c._ L k.V\.l --1 C A- t if 1 U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires February 28,2009 National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name /G„ ,/A�1 /3 6 Policy Number A2. Building Street Address(including/A/pt.,Ll�ni�Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number City Ty,t3 -y^5 A'P State ZIP Code 313es A3. Property Descriglion(Lot and lock Nurnberg,Tax Parcel Nu er, ga escri Lion, tc.) 5 C fc ,,r ►%ems . o 60 6(:g ce;h5 ec) A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) / ' S/Q"2.'7 6Q A5. Latitude/Longitude:Lat. Long. Horizontal Datum: ❑NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photographs/of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 7 A8. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provide: ) a) Square footage of crawl space or enclosure(s) IV sq ft a) Square footage of attached garage /' sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attachedg rage enclosure(s)walls within 1.0 foot above adjacent grade_W___,47. walls within 1.0 foot above adjacent grade N`'_ c) Total net area of flood openings in A8.b .,f ,7 " sq in c) Total net area of flood openings in A9.b /A-6;21_ sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community e&Community Nti b_er B2.Cou Name B3.State ,- TK&EE 6LANb / 5 1( C//ATNAAll -- B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9 Base Flood Elevation(s)(Zone 3C164/e'n.q 0 Date_ Effective/Revised Date Zane(s),. AO,use base flood depth)l B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑FIS Profile [' FIRM ❑Community Determined ❑Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: E NGVD 1929 ❑NAVD 1988 ❑Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes . 'No Designation Date ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: El Construction Drawings* ❑ Building Under Construction* 11 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-g below according to the building pdiagram specified in Item A7. , Benchmark Utilized .70.. !G" Vertical Datum Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor) /4- .e L_I feet ❑meters(Puerto Rico only) b) Top of the next higher floor Yl,,4- . feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) N A _❑feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) /VA _❑feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building /s- .5__D feet ❑meters(Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent(finished)grade(LAG) [g`r`eet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) -1,3T-. [feet ❑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. .a tg I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. ; 4„ /* �. may' . " Cs ?ItOI` L!Check here if comments are provided on back of form. „IT`S -,!., e 4j r 4t" 1 Certifier's Name �Q ` r it/1 (t /� License Number ! 1 `s t .� K I ., Title Company Name ,-7 1.t l 1/;141 t iC.�Y1 1) S1; 'It."`, ,,� Address - �, State ZIP Code _y! Signature,.'"`�7 r"' Date Telephone • , . . 4 FEMA Form 81-31,February 2006 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Building t Address(including Apt.;Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number City- State ZIP Code 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 > ¢. Signature •re , 1 t, ` Date '�: C3 7 ®'Check here if attachments SECTION E- =UILDING ELEVA I INFORMATION(SURVEY NOT REQUIRED)FOR Z NE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items El-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items El-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,crawl space,or enclosure)is ❑feet ❑meters ❑above or ❑below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Sectigap,Items 8 and/or 9(see me 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is _ ❑feet LI meters ❑above or LI below the HAG. E3. Attached garage(top of slab)is 0 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 owner's 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, U 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 Local Official's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: Building t Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number City State ZIP Code Company NAIC 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. I— vi li ... t., ilIIl dill , !11s , II � iih �,, II i iii III I •1=I''"'11011111111111111111111110111111111M1111111111111111 IIIIIIIllllllll Will 11111110 1111111 11 gilt „+i N 1 III r I alt . rte.: _ — 'all' III__II11111111I1131III IIIII,IIIII IIiIIIIIIIIIIII IUIIIIIIII�III IIIIIIIIIIIIIIII I it °t P 4 ill 1111 v -R ll--2 i II IIIIl.111111 III 111011111111 IIIIIIIIIIIIIIII 1111111IIIIII11 111111111111111 1111111111. o� J r S= - I .1`1 ,E1--- . / Ai U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No.1660-0008 Expires February 28,2009 Federal Emergency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: . Al. Building Owner's Name ,, e,/`A C G5 j , Policy Number A2. Buildin treet Address(in ludiing�A/pt.,pnii Suite,sandd/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number City 7--ye - ! J 09 A,.i? State ,, ZIP Code 31 9e A3. Property Descri. on Lotand lock Numbe Tax Parcel Number,Le al Description,^.) 5 ca brow Mull • 416 ') 44 co. A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) l41 eSfC/ali l/Q A5. Latitude/Longitude:Lat. Long. Horizontal Datum: ❑NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photograph of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number A8. For a building with a crawl space or enclosure(s),provide: A y A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) 6V sq ft a) Square footage of attached garage I sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached wage enclosure(s)walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade Ai t j c) Total net area of flood openings in A8.b /1/ sq in c) Total net area of flood openings in A9.b Ni`t sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION BI.N IP Community��mme&Community N r e l B2.County Name „ B3.State `„ �' , 1 y E c �[- .A N b / '../'A/it 4//1 ! ,C.,1, - B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel BB.Flood B9 Base Flood Elevation(s)(Zone 13C164160o1 Date. Effective/Revised Date Zpe(s), AO use base flood depth) at �q. r� At, `i BI0. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9, ❑FIS Profile EIFIRM ❑Community Determined El Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: IJ NGVD 1929 ❑NAVD 1988 ❑Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes Et No Designation Date 9 CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: ❑Construction Drawings* ❑ Building Under Construction* 9 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-g below according to the building diagram specified in Item A7. f Benchmark Utilized ” f' Vertical Datum ' Conversion/Comments ��// Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor) /``. . L feet 9 meters(Puerto Rico only) b) Top of the next higher floor l 4- . / 9teet El meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) N A _El feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) /V _❑feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building /C .5_2-feet ❑meters(Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent(finished)grade(LAG) . ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) ---L-.7-4---° ®'feet ❑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 x information. I certify that the information on this Certificate represents my best efforts to interpret the data available. . , I understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code,Section 1001. '- 4 1 '' I=l Check here if comments are provided on back of form. `(.\ ' ( 4.0, 15!1 Cs License Number ``°t P- Certifier's Name i�0 !0 r° C /(//1 l/f lj' /56 L l'1 Title p 4,el to 1, --+Comp y IName aFS 0 6 o f o v t f t 1/kr.'+ 1 4 i �r 5 � .ti Address ,� Crt State j ZIP Code » . jp Signature \t �` Date Telephone • /o7 ,. FEMA Form 81-31,February 2006 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Building Stet Address(including Apt.;Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number City State , ZIP: ode 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 . ! , Signafbre C • `(��c Date 12-6"5?)QA: x�( 0 Check here if attachments SECTION E-BUILDING ELEVATION FORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items El-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items El-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,crawl space,or enclosure)is _❑feet ❑meters ❑above or ❑below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Sectign4k Items 8 and/or 9(see ease 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet U meters ❑above or U below the HAG. E3. Attached garage(top of slab)is ❑feet❑meters ❑above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is J❑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 owner's 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 taw 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 Local Official's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, February 2006 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. Policy Number 57 City- State ZIP Code Company NAIC 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. •.. 17C 1.oa. iii 1 V ‘-t) III 11111.10 1111111111111111117 1111 1 p=1" '111111111 1111111111111111 1111111111111111 III11101IJIIII 11111111E 111 hlcll 111111111 111111;1 !!1111!!!!1 {"a lIt, 7rinv• 41 • _ r 1111111 10111 111111111 11011111111111 III IIIIIIIIIIIII t--(0 II 1110111111 jlil 11111111111111 1\1 \il: .444111111111 _ Ampum 5 ,;__..., ,... ,5f.,...••---•:;;',,t 44 1 Inspectton Report Ck tv o Tybee Island , 403 Butler Ave. Box 2749 Tybee Fsido41, GA 31328 Pitone:: (912) 786-4573 ext. 114 1 r-iix (9212) 186-9539 I ' $3.•: 01-110: .h.1 p_ 0 9 . ,..,, 0 -7 D1- C --, a 47 s R.?rpl.:., 1-17,1 I o 1.ts,j f _ CORmitl -"-- ,..--- nate Neded _ -_ --2) -o -7 Cr r4.. Contractor Subcontractor i ''\ ' 1,-- ( '--' 3 0 3 3 0- 71-1 ( I co Number ,1 j , -r ) ,..._ c.. - 7 y ^\ 0 /..) .. , 1 I . (' cyl 1.f.pcatktn ...-1 I 0263,ir` S / , 7 2._ ,...D--f- ‘(,,,--j / 7 Date. of Inspectio.n — ------------ TypP, of- inspection --------_-7----------- . (-7 , to Pass , ii..1 . ■ cl I 9XSO (6)1 di . ±- 1 --r- ,r•a . I I — , 1 0 tiv.re fl -i- , - -c. 0,N o...... 1 1 i C --es---1- 1 4 r , Inspection Report ..,....„- city of Tybee Island J . (1- 403 Butler Ave. 7)0 . r,.. --r P.O. Box 2749 Tvbee 'stand, GA 31328 Phone: (912) 786-4573 ext. 114 1 • j- F4X: (912) 786-9_539 Permit No _ Cri - O_Q 2 i nate RecitiPsted 1 ) - 10- 0 7 .---7-2, owner•-•-i. Name 0,...)L) 5 2_ nate NeeflPel 12 - (1 - Gen. Contractor Subcontractor Contact Number .1)t C --1 ( ;2 3 i 3 3 0 41U( Location 1 .----7-\ 1 Inspector ,\ ,----r• Date of Inspection Type of inspection ---X7--T- 1 Srl - - Pass M Fail 0 _ igAss 6") 4'. (, a ■ 1,-) , -r- ,p,S& I 1 i —I____L_QP1/4St9 /4? 9 -i-e r‘c■ 0 p L,-)R-5---- 0, *************** -COMM. 2NAL- ******************* DATE DEC-11-20f **** TIME 10:04 ******** MODE = MEMORY TRANSMISSION START=DEC-11 10:03 END=DEC-11 10:04 FILE NO.=574 STN COMM. ONE-TOUCH/ STATION NAME/EMAIL ADDRESS/TELEPHONE NO. PAGES DURATION NO. ABBR NO. 001 OK a 3062646 001/001 00:01:05 -CITY OF TYBEE ISL. - ************************************ -CITY OF TYBEE - ***** - 912 786 9539- ********* ethk WI II.ss RELEASES FOR ELECTRIC SERVICE FROM TYBEE ISLAND FOR SAVANNAH ELECTRIC.FAX TO:Lynn Brennan 9437 Phone 912-443-5063 017,-Q 02) 2.. ct V _'sV f(t.st o r� t r �y Location Address: 59 614/74 ins Lot# Release Date: /(2-ii--0 Type of Release: .Temporary /Perma'nelt Subd Name: Electrician: J; rAa-- E`o 6 . Electrician Phone Number: 5{f /- S 3 (. 31)330 Owner/Builder: L.I j..a S 2- Phone Number: - t Location Address: Lot# Release Date: Type of Release: Temporary Permanent Subd Name: Electrician: Electrician Phone Number: Owner/Builder: Phone Number: Location Address: Lot# Release Date: Type of Release: Temporary Permanent Subd Name: _ Electrician: Electrician Phone Number: Owner/Builder: Phone Number:_ 1111& 01111- WI 11N WVAN. i RELEASES FOR ELECTRIC SERVICE FROM TYBEE ISLAND FOR SAVANNAH ELECTRIC. FAX TO: Lynn Brennan 7 Phone 912-443-5063 3010-2loy10 44 O �-oo 2 D C V� o-c dv f( x o �6) Location Address: •-9 a iA i n S (./ t ,J Lot# Release Date: /2-/f-cD 4 Gm p.p 0�► Type of Release: .Temporary J/Perma'nent Subd Name: 1- � (a3�. 5� 5��3 Electrician: t ; rvx�� E`o G , Electrician Phone Number: 7 C 411 OwnerBuilder: , c- C) S Z Phone Number: 3 30- Location Address: Lot# Release Date: Type of Release: Temporary Permanent Subd Name: Electrician: Electrician Phone Number: Owner/Builder: Phone Number: Location Address: Lot# Release Date: Type of Release: Temporary Permanent Subd Name: Electrician: Electrician Phone Number: Owner/Builder: Phone Number: (___) %_.,--\/ ■ ■:.<4. :!., : Inspection Report. City of Tybee Island 403 Butler Avenue e u P.O. Box 2749 Tybee Island, GA 31328 Phone: 01.2) 786-4573 extension 114 FdA: (912) 786-9539 Permit No, (9q —( re 7 Date RPgilea-ed Owner's Narn-P ...B. 6132. Date Needed Ja4ipk 4e 77-3-7/6-- Gen_ Co ntrac tor finkint7 Cia) kf C t" Subcontractor ,, ), I ,..., .-,4 -r , - i 4C- . Contact Number a)le. k 6;7130 330 - 4111 7 , Location 51 "1— Enpector - c.. — r nate of Type CA' I nsz pPrtio n r/A/ 0 / PL —i- eis,9 / ki 1/4/ C. —1— Pass 0 -r-e'. i A T ige-Lie r Y-A 610 Fail 0 c A\4 x 70 *************** -COMM. RNAL- ******************* DATE NOV-14-20 **** TIME 10:41 ******** MODE = MEMORY TRANSMISSION START=NOV-14 10:39 END=NOU-14 10:41 FILE NO.=477 STN COMM. ONE-TOUCH/ STATION NAME/EMAIL ADDRESS/TELEPHONE NO. PAGES DURATION NO. ABBR NO. 001 OK a 3062646 001/001 00:01:05 -CITY OF TYBEE ISL. - ************************************ -CITY OF TYBEE - ***** - 912 706 9539- ********* W.1 1111_Jr .:Icl `1, RELEASES FOR ELECTRIC SERVICE FROM TYBEE ISLAND r„lr��i{ FOR SAVANNAH ELECTRIC.FAX TO:Lynn Brennan 9357 Phone 912-443-5063 t 5 Q(a- 446 44.403.V449 O 1 00 2`j o.,c .0 p 40c r Location Address: 6 j'j ea_pta;nts Lot# Release Date: I I-14—oi Type of Release: Temporary ZPermaheint Subd Name: Electrician: , MY1 E eft), Electrician Phone Number: .- Owner/Builder: ;4., ?5 2- _ Phone Number: Location Address: Lot# Release Date: Type of Release: Temporary _Permanent Subd Name: Electrician: Electrician Phone Number: Owner/Builder: Phone Number: Location Address: Lot# Release Date: Type of Release: Temporary _Permanent Subd Name: Electrician: Electrician Phone Number: Owner/Builder: Phone Number: rei,V c.. c. RELEASES FOR ELECTRIC SERVICE FROM TYBEE ISLAND FOR SAVANNAH ELECTRIC.FAX TO: Lynn Brennan 91337 Phone 912-443-5063 50(o- 2loLit_ .Q'1 -ooz1 C V2 0c' clop le. c. oetl�� Location Address: 6'7 ea 1:40.,,n+S V:eu.) Lot# Release Date: 114 4-o-1 PP 9r Type of Release: .Temporary /Pi "" rmaheht Subd Name: Electrician: 4\ I Yrt o-� �e�, Electrician Phone Number: ( . (-1;OwnerBuilder:�{ ; L �d J S Z Phone Number: 6330 Location Address: Lot# Release Date: Type of Release: Temporary Permanent Subd Name: Electrician: Electrician Phone Number: Owner/Builder: Phone Number: Location Address: Lot# Release Date: Type of Release: Temporary Permanent Subd Name: Electrician: Electrician Phone Number: Owner/Builder: Phone Number: N., O.-.• 41 1.1 • • • - ,ts ;• Inspection Report City of Tybee Island 403 Butler Avenue P.O. Box 2749 Tybee Island, GA 31328 Phone: (912) 786-4573 extension 114 Fax: (912) 786-9.539 Permit No- _ on 0 2 Date Requested C - Owner's Name T) 2- Date Needed Cl — - 0 ) Gen. Contractor Subcontractor contact Number --1), c \I) 3 3 3o - location I + 59 0 , n4 0 S Inspector Date of Inspection- Type of Inspection tf• I (.2 0 vm Pass E rj Fait Li •-• - ' 114 EC.,1 kc.4- i * ■ inspection Report City of Tybee Island 403 Butler Avenue P.O. Box 2749 -lybc,,,,e Island, GA 31328 Phon (912) 186-4513 extension 114 Fax: (912) 186-9539 PProntt rirt - 0 2 nate Flogilta.gt-Pri Ovaror Date Needed D7- 3-o-2 Gen, Contractor Subcontractor Contact Number \-4> 3 3 3 3 f H Location Inspector Date of Inspection Type of Inspection -r 1'0 , r\ Pass Ei Fad Li . 1 ' ',;,\‘' •V:4' I Inspection Report City o Tybee Island 403 Butler Avenue P.O. Box 2749 Tybee Island, GA 31328 Phone: (91.2) 786-4573 extension 114 Fax: (912) 786-9539 .--0-7 -)- Permit No- CO1 nate Ret-Itiested 1 f-->-- to--) 1 -- Owner'5 Name Date Needed _ i Gen. ContractorthMin ,.)\)2-Z Subcontractor Contact Num be v ey,'..- 1— '5"2„f0 .---4-I 1 ( I I Location ''-7 CIA-PIA( ILYS \I !EIA) 4- 6FO-hCTA--C -\I leVJ Inspector 612A0 eaLlafir) Date of Inspection airgi k2t A A Type of JrNspertiosi fl ( LL---' Pass E Fail 0 7 , t .‘ • ' ' • •• • Inspection Report City of Tybee Island 44)3 ft tler Avenue. P.O. Box 2749 TyI IslandLy GA 31328 Pitone: (912) 786-4573 extension 114 Fax: (912) 786-9539 Permit tio_ OQ 0 Q1 Date Requested ovvrw?,'s artw \ri-) Date Needed 0 Gen. 17.0 retract.°r Subcontractor 3 ( 3 3 — 4-(- t 1 c...ontact Nurnb49r ,2 ‘15'‹ (2 -1-- ,(Th, Location . 0 inspector nate of jrgsr_wr ro Type (-.!! n:75.61F,q-ji rf 7) CZ Pas-s r"""1 "PY.4 •mi ••12' - - : • inspection Report City of Tybee island 403 Butler Avenue 1 P.O. Box 2749 Tybee Island, GA 31328 Pimple: (912) 786-4573 extension 114 Fax: (912) 786-9539 Permit Pin, Date Requested (co-2.-1-0 7 Owner's hi aisle .5 2.- Date Needed Gen: Contractor___ subcontractor Contact Number 3 6 3 3o 1-{ it Location 517 6-9 0007y-A r■ k/ 0.) *0*—) Inspector et) Date of Inspection 631 Type of Inspection 4 . P Lki 0. Pass \t- QML 0 F 1.1\ t4h-S Fait COQ PLrW Meir15 rnoie/tiivj -I— _S 0 1< Jo vo\ie _rocuuArd .44-6 7 tAAAA-74- I '1, 47. , . ) Inspection Report City o Tybee Island 403 Butler Avenue Box 2749 Tybee Island, GA 31328 Phone: (c 12) 186-4573 xten 114 Fax: (9;2) 786-9%39 •‘ -2 - (Th C52 -7 0 -I te RequPsted r —— 3 owne.rd5 Fl Date Needed Gen, Contractor _ Subcontractor \• L 1) -2 ) 2 i ntact Number 1- 0 , 4. 9 0 ,r'‘ Oration r LI/3°41 Inspect:a _ Date of Ins,pection P p.S4p Type of Inspection P • Fail • j • /e 1 I LJ fri) WOT • 1(1) i0 ) 10,4'1.11) 10i ( J • A (--) ,61„) - _ " . . . . _ : " 1 , : . ' , : - , , ' . : : : ' : ; : i , ' ' , , , " . ' ' . . . , " " . 2 1 : : : 1 i , . . , , , . . , 0 % - ' i n s p e c t i o n R e p o r t C i t y o f T y b e e I s l a n d 1 4 9 3 B u t l e r A v e n u e P . O . B o x 2 7 4 9 t y b P t c - . . I s l a n d , G A 3 1 . 3 2 8 P h o n e , : ( 9 1 2 . ) 7 8 6 - 4 5 1 3 e x t e n s i o n 1 1 4 F a n : ( 9 1 2 ) 7 8 - 9 5 3 9 " - ) C ' 0 - ; Q - - , f i a t e R e t i t t f - s i t e d ( D L - i - 0 S - - 0 7 D a t e N e e d e d - S e a . 1 2 i 3 . 1 . - J : r a r . - t o r k , t ( - , 1 - . - - ' ' ' 0 3 3 D - - - - - t \ I ' - o n t a c t N u t y k b e r ( c - ) i 1 . . - 0 , c a u e r t - " 1 - - 7 - - r . . . s T r . i n s p e c t o : 7 E l a t e o f T h s p e c t i o n . " ` P , - 7 , 1 1 , 7 . c , , 7 r k . C . n I T . ; p - . 7 . 5 , 7 1 . k f i : ' . _ _ _ _ " _ _ _ _ - _ _ _ . . . . . . . . _ c ' _ . r . . . . . . . . L . . . . g " 0 P a s s , v i I " , . . _ " N . . - - t o c r a m s . . 1 1 f a i l i I 6 , - . . . . . . 1 . . " , . , , " , J . , - L . , J ' 1 ' - - I l i / . . - - - ' " : ; ' ' " ' - ' l . - . . / ) I r - - / - : . , - , ; . 1 . : L - i t , / , ! : , I L , / - - , - 1 . . i . i / 1 , . . . I . A ' . �% t \ , . i / ) . . . . , . . , ; . - ; i _ . . i . ' . . . . _ . . . . - . . . , , : _ t ) I . . . 1 ' " " I ` . k ' , 2 - - - , It • • • Inspection Report City of Tybee Island 493 Butler Avenue P.0_, Box 2749 Tybime Island, GA 31328 (91;1 186-4513 extencion 11.4 FiliC (c12) 785-9539 rt: 0 a 2 -7 Requested 4.4-at 0 -> frit,merE Nio5iFt s Date eeded — ntracto r Su be°ntracto r Li C, '2 30330- / Hi contact a am r r-7 . Location r..nspecto,r Date of Inspection (Yls Type n5pectio Q1162106$ U T _L1h6-a:----r7fCrr* / , ' A 0 t-c-7- ACt., TLc Aii„, (-7 C • • • ' • • „ ' • _,: ::•Ili 7.i*. '‘ •• ....V ; - 4..i4 1.p.;. ..0,1ecticitn Report (Az)/ of Tybee Ii 403 Butler AVolitte PD. Box 2749 Tybee Island, GA 31328 12) 186-4573 ext.f,_,Jocis 114 • Fax:: (912) 786-9539 Permit D o _T7 Date Re:ques,ted - -7 to, Ovianar's Name D32 . Date Ptaelled 03 Gen. r..:f.)13tractor Subcontractor Contact iCtrirnber cg I .2) 0 ' ” toctoe /9 Ca S e (.. D F;te of i Ci4voritC2 T ime Inspector o pectoi --- - j % b .7) 1—J ^.- 1'7) . (' S's.-- 9 F.- • 1 . U\--1 k .i .,`; t.; :*:-..t,. , X:',;.!. . ' ::'.:'.; '• . , k•. t 7 , 1,....e •fr•. I / I rt s pectIon Report CAI, of Tybee Island 403 Butler Avenue PO. Box 2749 Tybee Island, GA 3132 Pi on,P.: (912) 786-45T3 extens$on 114 Fax: (912) 786-9539 Di -Th 2--.- Perm -i-. N ni_ - k......., \-7) Date Requested ,---Th 5 03 — 1 =,:s) — o7 Date Needed . Ge;iI, tItror Subcontractor _ _ 7 Contact rt wnber ' ) , CI ) / 6 0 / t `--d ..., i im--- -- i_ocaton ( „ --/ .., - / W7,.) : ( 4-4 1 71srtez- -ipin ,. _ -_-_,, ‘,..-2 Time Incnector -, -- Type f-'f i t-IfT,,F,rtik-4 yi (.' 1 1 _...,_ ; / 7 (-,1 •- . . CITY OF TYBEE ISLAND WATER METER PICKUP DATE ISSUED: 02/14/07 PERMIT#: 070027 WORK DESCRIPTION: NEW RESIDENTIAL BLDG-DUPLEX WORK LOCATION: 57&59 CAPTAIN'S VIEW OWNER NAME RICHARD BUSZ ADDRESS 667 US 131 CITY,ST,ZIP BOYNE FALLS MI 49713 PHONE NUMBER CONTRACTOR NAME RICHARD BUSZ ADDRESS 667 US 131 CITY STATE ZIP BOYNE FALLS MI 49713 FLOOD ZONE BUILDING VALUATION SQUARE FOOTAGE 5582 OCCUPANCY TYPE P TOTAL FEE'S CHARGED $12,049.00 • PROPERTY IDENTIFICATION# PROJECT VALUATION $750,000.00 ONE WATER METER(3/4-INCH) TOTAL BALANCE DUE: $ 0.00 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 glitter 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: CIA;pSZ. (0 P.O.Box 2749-403 Butler Avenue,Tybee Island,Georgia 31328 (912)786-4573-FAX(912)786-5737 www.cityoftybee.org r-- ) • •=::.,- Ifri-5-412ction Report ciqv przpanti •103 eutior Amemick 11.20. Box 2749 "1"vhf-IR, Island, GA. 31328 PitcfrYiPP: 03:21 186-4V/3 i,Axtemsion 114 Fd (912) 7E35-9539 0 ) 7 I 0 02- ftt:1 S 2- te Ne& d O ..... !--.11134-4-intractor ritac tKiorn tb-P.r V ' ( 1 LocaboN ) L ,-, _s" V Date of T rtSpectian "Time I cis pectc..-/ ------- Type of I ansperton 9/A • '(4r;tY 11.. 1 I 'ff... ....Ye ••i 4V, y • Inspection Report city of Ty bee Island 44113 Nutier Avenue P.O. Box ; 749 . y bee Istarit GA 313 Phone: (12) 786-4573 xt nsi n 114 . File b ( ) 786-9539 / -1 I .awe-aY-•E .+pis a rg_ Contractor Subcontractor f ( ).-Contact Number __� _._.__ —_- — -3 I) Type zo ;i sec t o,,. 0 ii ..Q.,r` .� I C b r� 1 ,�, . , ;,;). rf 1r 1 • r---) ■r"---\, , ...'• , „ ... W .11.1,... -.....-- .. --,,,i.. - . y .:;.; 4 ,.. ..,..„ .;:„..:. „„, . ,..: ; . ..„. -i 0 if.,Z=4 Vf Vhcts,fe. 'CV 6,1 N IN A 11.1.0 C.7 8 t 1 C Chi' 0 t Tybee Isiand -403 Huber Avenue P:o. Box 2149 (... -",. Tyhee Island, GA 31328 1-v.itorie-..: (912) 186-4513 elEtension 1.:i.4 1 / Fax: (912) 786-9539 ii";)7- ,; Pel-aiit N 1.../ ----1..,' c,”- Date Requested Owner's 'Name ..._:L-?&.-i,:rj :::,' Date Needed ----- -i--'— Gen,. Ci'_;ntraor t,-;-' -,1.'..71,W.. Subcontractor --------------------- Contact fill"rilff..?er __--- -- L.- 7 ,- /-- cl ! • _ . • - . .,.,r. f ,I,i'1r• I P- ... --)/ 1 ‘,„_ .c2-2- e . . Date of 1-tasr:ectio 1 4 1 1 7140 .. 1 Time Inspector- ,-..7,-• ..1. it gAs6, 1 )„,.. .,.., ......„ ..... ,, , _..... i. ......._ _ ... ,_ Page 1 of 1 Dianne Otto From: Jimmy C. Brown Sent: Tuesday, January 23, 2007 3:02 PM To: Dianne Otto Subject: 57 &59 Captains View Diane, The duplex in Captains View will be 57 & 59 Captains View, FACING the Building 59 will be on the LEFT and 57 will be on the RIGHT, this will be in uniformity to the other duplexes in the subdivision. 59/57 Thanks for the Staples!! 0_ ack- (1 ' V 01/23/2007 CITY OF TYBEE ISLAND APPLICATION FOR NEW CONSTRUCTION BUILDING PPERMIT illt'.,..'% y sets of building plans VI copy of survey showing ground elevations&flood zone ^ ^—0 0 2 7�a ' $250 plan deposit Location: / zn ila t V; PIN# NAME ADDRESS TELEPHONE Owner / Architect or Engineer Building Contractor 14 6 .t 0 w ue (Check all that apply) ErNew Construction ❑ Residential ❑ Other ❑ Single Family [ `Duplex ❑ Multi-Family ❑ Commercial Details of Project: %-.7 \L 0 - Estimated Cost of Construction: $ 7501 no a' Construction Type a (Enter appropriate number) (1) Wood Frame (4) Masonry (6) Other(please specify) (2) Wood&Masonry (5) Steel &Masonry (3) Brick Veneer Proposed use: 6..C.' I cI e t c c. Remarks: ATTACH A COPY OF THE CERTIFIED ELEVATION SURVEY OF LOT and complete the following information based on the construction drawings and site plan: #Units 2_ #Bedrooms 4 A Z = #Bathrooms 4 X Z Lot Area 6 goo f t Living space(total sq. ft.) Z. Ti i x7, e. #Off-street parking spaces Trees located &listed on site plan 2_ Access: Driveway (ft.) With culvert? 11 0 With swale? vl C) Setbacks: Front Zo ' Rear Z. `/7/d L7 e Sides (L) i 1' (R) /0 #Stories Height 34-/14 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. During construction: On-site restroom facilities will be provided through I 0 VI S On-site waste and debris containers will be provided by Construction debris will be disposed by 1t0 by means of ,ti, s r . 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. 7 Date: 2 ' C) L Signature of Applicant: Note: A permit normally takes 7 to 10 business 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 P1 0s'4-1'Yamk°Z s 2, �`'' :13s car 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: Si y fe // Date FEES Zoning Administrator ■ r; .. _ / 0, Permit 2i JO Code Enforcement Officer /— / — p Inspections 4,957 Water/Sewer / � _ _ Water Tap 530 S Stor i/Drainage ewer Stub,� 5'SU � Aid Aid to Const. Inspections .;_�� �� � �� City Manager Jr>,I . _�tje i `,L� r` '-/r CC Recovery 40(.,,C> -- NDre ; xt 25. w/S T.Q p S b AZOIrl be-0010; o TOTAL /2 1+61 REQUIRED FOR: Building Permits Relocation Permits Sign Permits Demolition Permits Land Clearing, Disturbance or Excavation Permits Tree Removal Permits Relocation Permits Special Review Permits Site Plan Approval Subdivision of Land Sketch Plan Approval Preliminary Plan Approval Final Plat Approval Minor Subdivision Plat Approval Major Subdivision Plat Approval In addition to specific requirements for the above permits and approvals, applicants must demonstrate that they are in compliance with the City of Tybee Island Storm Water Management requirements as outlined in Chapter 5-4, Code of Ordinances. Section 5-4-9 Prohibition provides, in part, as follows: (4.) It is unlawful for any person to cause or permit any storm water to flow from their property onto the property of another person,unless such storm water naturally flowed thereon prior to any development activity. (5.) It is unlawful for any person to interrupt the flow of any storm water runoff from adjacent property onto their property by any development activity. As part of the City's approval process applicants must illustrate how these storm water management prohibitions will be met, including a showing of how storm water naturally flowed on the affected property(prior to any development activity), and what changes in storm water flow have occurred or are expected to occur, as attachments to this form. The City's approval or permit does not guarantee that the applicant's plans will result in meeting requirements. The final product must actually meet the City Ordinance requirements. Applicant name: Project I.D.: Attachments approved by: Date: CITY OF TYBEE ISLAND BUILDING &ZONING DEPARTMENT P.O. BOX 2749 TYBEE ISLAND, GA 31328 PHONE(912) 786-4573 FAX(912) 786-9539 FEMA Certification of Elevation is required for structures in a Flood Zone. Location of Work: S 7 C(fY c,Lr t is 1 k Owner's Name: R-\ Address: 4) Contractor's Name: q;,. . w R.. .1-- This notice is to confirm our understanding that all equipment such as air conditioning compressors, water heaters, furnaces, electrical outlets, meters, etc., are not permitted below the required finished floor elevation. By accepting the building permit, I (owner/contractor) agree to construct/place the equipment above or up to the required finished floor elevation, which is stated below. BFE Acknowledged and agreed to this Z day of t4 , 20 0 7 . Lgot/ Owner/Contractor Signature cl„moo L 1 u5a Owner/Contractor Printed Name STATE ENERGY CODE AFFIDAVIT Location of Work: S 7 Owner's Name: + ��� =C TS Address: C 7 r9 7` V c Contractor's Name: -e c i,, e c- This letter is to confirm the understanding of the owner/contractor to the compliance requirement of the Georgia State Energy Code for Buildings, 2000 Edition. I hereby declare that the design and construction of the above referenced project is in compliance with the Georgia State Energy Code for Buildings, 2000 Edition. It is understood and agreed by the undersigned owner of agent and contractor(if applicable) that the approval of the permit does not constitute a privilege to violate the Code and that any omission of or misrepresentation of fact with or without intention of the permit issued which was based on the approval of this application. The owner as listed above will be held responsible for insuring that all permits have been obtained and that all required inspections have been made. The owner will be held legally liable for any violations which may occur with or without his knowledge. The owner shall be allowed to request a Certificate of Occupancy when all inspections have been approved. { — a _ 0 Owner's Signature J Date Owner's Printed Name Contractor's Signature Date Contractor's Printed Name PERMIT FOR INFRASTRUCTURE ALTERATIONS Location of Work: C--- -t0. vt S V 1 < Owner's Name: iet C_,/&O./'C. E c Address: 5-2 Contractor's Name: 11L 6 l a_} 1,7 /- NOTE: Any alteration to City owned streets, curbs, sidewalks,waterlines, sewer lines, drainage pipes, catch basins, or other elements of the City's infrastructure,requires a permit from the City,and an acknowledgement by the individual seeking to accomplish the alteration,that: a. The City's infrastructure will not be degraded in any way. b. All necessary safety precautions will be undertaken. c. The City will inspect the work in process and upon completion. d. The work will be accomplished to the City's satisfaction. e. The City shall be held harmless of any liability or damages of any variety. f. The individual has read applicable portion of the City's Code of Ordinance dealing with the alteration, and agrees to fully comply with such provisions. Description of alteration: ' _ A sketch or drawing must be attached illustrating the planned alteration. Attached? City Design Standards and Specifications: All alteration to the City's infrastructure shall be accomplished in such a fashion so as to restore the infrastructure to essentially the same condition that existed prior to the alteration, or to an improved condition, as determined by the City. Certification: I hereby acknowledge the above requirements, and certify that I will perform the above described alteration in accordance with these provisions. cf .. . t 6 7 Owner's Signature Date et.e.� S Owner's Printed Name Contractor's Signature Date Contractor's Printed Name APPROVAL Zoning Date Building/Code Date Water/Sewer Date Drainage Date CITY OF TYBEE ISLAND BUILDING &ZONING DEPARTMENT Temporary Electrical Service Affidavit Location of Work: Cetpt 5 Owner's Name: i‘3"_,G0 Cy Z Address: c 7 c 1 1- r, c 1.4 C Contractor's Name: /40.1----Q I, 0 �~ This letter is to confirm the understanding of the owner/contractor to the compliance requirement of the Georgia State Minimum Construction Codes. "I hereby declare that the requested temporary electrical power is intended for the completion of the construction process and the testing of equipment installed within the structure." It is understood and agreed by the undersigned that the issuance of temporary power DOES NOT constitute the approval to occupy the structures. A Certificate of Occupancy must be issued by the City of Tybee Island prior to the structure being occupied. The owner/contractor is hereby held responsible for any violations to this policy. A violation of this policy may result in discontinuance of the electrical service. � -� — 2 Owner's Signature Date Leck L 7 Owner's Printed Name Contractor's Signature Date Contractor's Printed Name Witness's Signature Date Witness's Printed Name CITY OF TYBEE ISLAND SUBCONTRACTOR LIST Location of Work: ? — `f-L y,,�S -e Owner's Name: i� � z,S Address: S 7 1 �L t Contractor's Name: Po e w e r List the company name, business type, address, license number, contact person and phone number of all participating subcontractors. 1. Company Co iiPtels-e P ._ n 14,„1,x-. Business Type P oatak. recd.-t I i % Address Z t i S' Cu51Le r kr/ License Number g ow 39 A. 4s / �r 48 3 / Contact Person V ,-1 Phone Number 2 3 51.1 3 3 3 .6 2. Company Business Type Nl.e ,.,, Address License Number 7 1 0 Z- - Contact Person VILA...IL L . Phone Number Z S I - SZ 1 — 3 333 3. Company J 1 �1 �; Business Type -+2G1'rt f I Address \ '2 8-60 y .o r- f2 License Number 6 / b 4® /C CL rfevchc kr 417zO Contact Person .5211 6,,, ., Phone Number L - c¢-7 — S g 3 4. Company Business Type Address License Number Contact Person Phone Number 5. Company Business Type Address License Number Contact Person Phone Number Attach additional sheets if needed. U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No_1850-0008 Federal Emergency Management Agency Exoires February 28,2009 National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For insueonde Company Use: Al. BuJldl . 9Wn:h's A Iiiiiii 2. Buildinggtree dress(including Apt„Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIL Number City 7� 5 /to,.1I nc Vie 1 /ad .E t sla-t,.tvt State A ZIP Code 1 3 ea A3. Property D=scrip n(Let and Block Numbers,Tax Parcel Nurn r,Legal Description,etc.) L ? Cap4 CNA net, O to.. - A4. Budding Use(e,g.,Residential,Non-Residential,Addition,Accessory,etc.) g c5 A5. Latltude/Longitude:Lat. Long, Horizontal Datum: ©NAD 1927 NAD 1983 AR. Attach at least 2 photographs of the building if the Certificate Is being used to obtain flood insurance. Al. Budding Diagram Number A8. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) sq ft a) square footage of attached garage sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade wails within 1.0 foot above adjacent grade c) Total net area of flood openings in A81 sq in c) total net area of flood openings In A9.b eq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 01.NFIP Community Name&Co un Number _ B2.County Na B3,State �l ee �s/k0 l3 M4 l' lta 4 B4.Map/Panel N leer B5.Suffix Be.FIRM Index 137,FIRM Panel B8.Flood 89,Base Flood Elavatlon(s)(Zone r7 / Date / 70/7 Date /�ane(s)‘74 /41 43 B10. indicate source of the Base Flood Elevation(BFE)data or base flood dap ed in Item B9, Q FIS roflie [FIRM Q Community Determined 0 Other(Describe) .., .... . B11. Indicate elevation datum used for BFE in Item 89: t� NGVD 1929 El NAVD 1988 0 Other(Describe) B12, Is the building located in a Coastal Barrier Resources System(CBRS)area Otherwise Protected Area(OPA)? U Yes Eta Designation Date ❑ CBRS OPA SECTI -BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: Construction Drawings" Buiiding Under Construction' ❑ Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones Al-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 02.a-g below according to the building*gram specified in Item A7. Benchmark Utilized 12.TE Vertical Datu Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor) - loor) Jfeet U meters(Puerto Rico only) b) Top of the next higher floor 2 ..O1 L ]feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal etruct ral member(V Zones only) )1.1 Q U feat Q meters(Puerto Rico only) d) Attached garage(top of slab) feet i440 meters(Puerto Rico only) a) Lowest elevation of machinery or equipment servicing the building 11ft0 meters(Puerto Rico only) (Describe type of equ•,jpmant in Carrnnents) f) Lowest adjacent(finished)grade(LAG) *54e*e c eet U meters(Puerto Rico only) g) Highest adjacent(finished)geode(HAG) 1111-11—.11,111 feet ❑meters(Puerto Rico only) SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certifCation 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 Certirmate.repreeents my best efforts to interpret the data available. • I�undderstand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001, 4 0 It 0v •• K w*hews�+ hems Ore provided on bsek of form. ' 0 f'Npyt " zgc,Certifiers Name 1582. to . Title f 6.± , ' •,,, s f 7.c M t l 1 t " 7� •. � • Address ✓© 4+ :iii. s' .. Signature A. 1 7 Q >,n r i • al i1/Trffkil► FEMA Form 81-31,February 2006 See reverse side for continuation. Replaces all previous editions TO BEND Nt171IT1INel 00TOZ1,912ZL2 8080 L00Z/E0/T0 Ilai�rl��e. _ IMPORTANT: In these spaces,copy the corresponding information from Section A. :I ay. �'.,"' rte; Buildi • t •d -:: udL• it,$ylite,arbor=d• No, or P.O.Route and Box No CitY SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTWICATION(CONTINUED) Copy both aides of Ns elevation Certificate for(1)comrnu official,(2)Insure agenUcompany, (9)building owner. Comments it Signature 4C tfi!�'— Date Z""' (S ❑Check here if attachments SECTION 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 El-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 at#acent grade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is _❑feet ❑meters ❑above or Ed below the HAG. b)Top of bottom floor(Including basement,crawl space,or enclosure)Is ❑feat ❑meters 171 above or below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Sect..*LA Items t3 a istior 9(see woo 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building _0 feet L)meters E]above or LI below the HAG. E3, Attached garage(top of!lab)is_ []feet❑meters ❑above or ❑below the HAG, E4. Top of platform of machinery and/or equipment servicing the budding 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 owner's 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,end E we 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 attachm!nts SECTION G-COMMUNITY INFORMATION(OPTIONAL) . The local official who is authorized by law ordinance to administer the oortinittnftyr811o0dplaln management ordinance can complete Sections A,f3,C(or E), and 0 of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items GB.and G9. GI. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who to 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 commurty flootlptain management purposes. G4.Permit Number 05. bide Permit Issued G6. Date Certificate Of Cohnpiance/Oecupency Issued 07.This permit has been issued for. ❑New Cons*rut*on ❑Substeretha Improvement (38 Elevation of as-bust lowest floor(including basement)of the binding: . El feet ❑meters(PR) Datum G9.BFE or(in Zone AO)depth of flooding at the building eke ❑feet ❑meters(PR) Dam w Local Official's Name Title Community Nance Telephone $ Mgnatlr a Date Comments D pIll1S�here if altaanhmwits FEMA Form 81-31,February 2008 Replaces all previous editions Z0 39Vd 00T0T17917ZLZ 80:80 L00Z/E0/T0 zort7 / Y 5 5 7°44 z4"W 50.0`,-' /7 ti13• ° ast- r1r-- .If J _ 7:0a ,8l& se 64J ; _...g , , . !3,¢ N .�.• , weCX, I ) pecl I Sadd uIs/on i . 4 Abore/i _ 6/d5. s boc /0 ; x S .1- ( . .for �0 � L© 3 ,', ‘i ON /....‘ 6799 %265, a '1 it t. `� 1. 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