HomeMy Public PortalAbout11-0610 Derrickson CITY OF TYBEE ISLAND
BUILDING PERMIT
DATE ISSUED: 11 -7 -2011 PERMIT #: 110610
WORK DESCRIPTION REPLACE SCREENS/DECK BRDS
WORK LOCATION 1610 JONES
OWNER NAME S.G. & F.L. DERRICKSON
ADDRESS 432 OAKVIEW RD
CITY, ST, ZIP DECATUR GA 30030 -4324
PHONE NUMBER
CONTRACTOR NAME TYBEE GIRL HELPERS
ADDRESS 1303 JONES AVE
CITY STATE ZIP TYBEE ISLAND GA 31328
FLOOD ZONE
BUILDING VALUATION
SQUARE FOOTAGE
OCCUPANCY TYPE P
TOTAL FEES CHARGED $ 75.00
PROPERTY IDENTIFICATION #
PROJECT VALUATION $3,000.00
TOTAL BALANCE DUE: $ 75.00
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: OAP; A 2 01:4
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 • Planning & Zoning Dept.
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`s - } Inspection Report skalmota
,, 3 / 403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 INTE OKAL
-c Phone 912.472.5032 • Fax 912.786.9539 CODE couracIL
o /670 MEMBER
Permit No. // 2 id Date Requested t /L9
Owner's Name a ef le_ k 30,J Date Needed
Gen. Contractor Subcontractor
Contact Information } /
Project Address f 6 Id JoAM✓
Scope of Work 6410 6 5C tt45 ! PQK )Al2 DS
Inspector / Date of Inspection ,-/ ) „ (3
Inspection T /INJ / i Pass ®' -"\ Fee
Inspection Pass ❑ Fail D Fee
Inspection Pass ❑ Fail ❑ Fee
Inspection Pass 0 Fail ❑ Fee
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CITY OF TYBEE ISLAND, GEORGIA
APPLICATION FOR BUILDING PERMIT
)Io o Wi)
Location: \ (I 0 771/1.c / i r 'ALA) _ PIN #
NAME ADDRESS TELEPHONE
Owner
Lt 3 ')-.- alt (L- J ; , zz� - 5 er
Architect 3 Z
or Engineer
Building j � 6-,i' ktU I k V ( ' - % (Le S ALE. 4I 2- (
Contractor 0—Kt iI M... ot; � -'L►b t f t C cl C r 1
(Che all that apply)
epair [— Residential ❑ Footprint Changes
❑ Renovation ❑ Single Family ❑ Discovery
n Minor Addition I 1 Duplex ❑ Demolition
n Substantial Addition ❑ Multi- Family
n Other E1 Commercial !l 15
Details of Project: tr 0 /t_1 e_ ( V 4- i'`-f>4'
n ( ) n t>
Estimated Cost of Construction: $ ' Wyj —
Construction Type 1 (Enter appropriate number)
(1) Wood Frame (4) Masonry (6) Other (please specify)
(2) Wood & Masonry (5) Steel & Masonry
(3) Brick Veneer '' ff --
Proposed use: _ Q ' Y f '`!4% `,1C' C "C' V c_-i vy4 - fr)/9 1t3
Remarks: /71, „ ck
ATTACH A COPY OF THE CERTIFIED ELEVATION SURVEY OF LOT and complete the
following information based on the construction drawings and site plan:
# Units # Bedrooms # Bathrooms
Lot Area Living space (total sq. ft.)
# Off - street parking spaces
Trees located & listed on s' e plan
Access:
Driveway (ft With culvert? With swale?
Setbacks: Front Rear Sides (L) (R)
# Stories eight Vertical distance measured from the average adjacent
grade of the build' g to the extreme high point of the building, exclusive of chimneys, heating
units, ventilatio ucts, air conditioning units, elevators, and similar appurtances.
During construction:
On -site restroom facilities will be provided through c iJ (. lA, oTh
On -site waste and debris containers will be provided by ct,11 f - k-1t
Construction debris will be disposed by t1 , by means of De , ( � _ ; ,, ,p -
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: 11 _ 11 Signature of Applicantj G/l
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 Permit
Code Enforcement Officer Inspections
Water /Sewer Water Tap
Storm/Drainage Sewer Stub
Inspections Aid to Const.
City Manager
TOTAL ( CI
LEAD -BASED PAINT
Adapted from http: / /www.epa.00v /lead /oubs /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 Rioht: Important Lead Hazard Information for Families. Child Care Providers. IF YOU'RE NOT
and Schools. Owners of these rental properties must document compliance with this requirement. EPA's sample 1EAD SAFE CeAWEED.
pre- renovation disclosure form may be used for this purpose. - DISTURBING
After April 22, 2010, property owners who perform these projects in pre -1978 rental housing or space rented JUST SIX
by child -care facilities must be certified and follow the lead -safe work practices required by EPA's Renovation, SQUARE FEET -'
Repair and Remodeling rule. To become certified, property owners must submit an application for firm "COULD COST YOU
certification and fee payment to EPA. The Agency has up to 90 days after receiving a complete request for 'BIG TIME
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 recordkeeoina 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 Rioht.
• 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 Riaht: 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 ore- 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 Riaht: 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 ore - 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 eliaible 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 recordkeepina 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 Rioht.
• Red about how to use lead -safe work practices in EPA's Steps to Lead Safe Renovation, Repair and Paintino.
Signpture / ` Date
t et0 y
Printed Name � l I
ti ��r`
NFL OF W W1 �P )L'.EE
IIti0Y11C0 4,* p
6:711 r. ^yr 1.
GEORGIA
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.
I1ridersigned ) Date
Alp 4.36 2S-(2)
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Printed Name
Office Use Only:
Project Address:
Permit Number:
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BUILDING PERMIT
DATE ISSUED: 06 -22 -2011 PERMIT #: 110366
WORK DESCRIPTION INSTALL FENCE
WORK LOCATION 1610 JONES
OWNER NAME S.G. & F.L. DERRICKSON
ADDRESS 432 OAKVIEW RD
CITY, ST, ZIP DECATUR GA 30030 -4324
PHONE NUMBER
CONTRACTOR NAME TYBEE GIRL HELPERS
ADDRESS 1303 JONES AVE
CITY STATE ZIP TYBEE ISLAND GA 31328
FLOOD ZONE
BUILDING VALUATION
SQUARE FOOTAGE
OCCUPANCY TYPE P
TOTAL FEES CHARGED $ 61.00
PROPERTY IDENTIFICATION #
PROJECT VALUATION $3,200.00
TOTAL BALANCE DUE: $ 61.00
It is understood that if this permit is granted the builder will at all times comply with the zoning, subdivision, flood control, building, fire,
soil and sedimentation, wetlands, marshlands protection and shore protection ordinances and codes whether Local, state or federal, including
all environmental laws and regulations when applicable, subsequent owners should be informed that any alterations to the property must be
approved by the issuance of another building permit. Permit holder agrees to hold the City of Tybee Island harmless on any construction
covered by this permit.
This permit must be posted in a conspicuous location in the front of building and protected from the weather. If this permit is not posted
work will be stopped. The building contractor will replace curb paving and gutter broken during construction. This permit will be voided
unless work has begun within six months of the date of issuance.
Signature of Building Inspector or Authorized Agent:
P. 0. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328
(912) 786 -4573 - FAX (912) 786 -9539
www.cityoftybee.org