Permit 1107 Atlantic BoulevardDEPARTNZENT QF BUILDING
TOWN OF ATLANTIC BEACH, FLORIDA ~ ~ r
+'""` Application for Permit for
Miscellaneous Alterations,
and Repairs
Da~ Y, 1
Permit Nay, ~~ ~__ Fee ~_~
Valuation ~__~~~ ~=~ _..______
House No. ____ ~ - __
~ r.
To the Supervisor of Building: 4~ .
The undersigned hereby applies for permit ~~F-~~ __-~ !~.r~_ _ `,
(State 1f to rep~fr, alter, add to or move building; erect awning, sign, etc.; tn,~ta11 bailer, elevator, ete.J
Building on_______ ____.Lot No._.__ __ ___-__Block No._~____ ____________Sub. Div.___-__-
(State fracttonal Part) ~ ~-~--_-'
Ate--_Side No._ ,~_T!~~.I~i.T.l.~°-'B~,_-!~_-St. Between--_-__----Y_..._._...,and~_._.:,.,•---_---_-~ Sts.
Valuation 5--~.~ _~ ~ O U __--____ ~_~.~.1_Lk~_g 5_~ (~u~t.Li.~~----_._._------------_._..._._.__.Y.~~- -----
(State coat of improvemenq
BUII.DINGS AND OCCUPANCY
What is present use o! building-..Residential or Business?-___--____-____-------______-._~-
Ii residential, what type-Dwelling, Garage Apartment, Apartments or Rooming House?_.-,~
How many families accommodated now?-____ ___.How many when altered?.._..
I! business, what type?~___.._-_.._________..___.-...... __~_Will food be prepared #or gale o11 premises?.-__
What plumbing work to be done ? ........................ ........ .........._~._~ _._____~__ ,~_._.
Size o! present building __._________5ize of extension.-_~____~____--_ Sire o! iot
Number of stories now ................................................alter altered...._-_^___.- _-Material of roo# _____
Material o! present buildfng_--_ ____-__..__-______Material o! extension~_ __- _
NECESSARY PLANS IN DUPLICATE TO BE SUBMITTED HEREWITH
OTL BURNER OR GASOLINE EQUIPMENT
Name of 011 Burner or Gasoline Pump .............. ._.,..... _-_•--._._-- _Type or ModeL.~.___
Name and Address o! Manufacturer_________..:_....~_ ._._____.~. _
In connection herewith, application is also made to ixlatall:.._.-----_----•-__-_._..~ .:gallon capacity tank (a)
fHOw many)
made by__________ oi. .-~ wage metaL_.-.._ _.grouxtd
(Name of Maaalaaturer) ( ndtr or above)
._______of building. F'or,_~._
(Inrlde or outside)(Name-of Purchaser)-~^
FIIR,NISH DRAWINOr gHOWTNG ENTIRE LAYOIIT ON REVERSE SIDE OF TSI$ BLANS
SIGNS
~ ,. /
Sizes~~_~_~ .._ Classification.--___~_.u.cz_~ _..---------___.----_~_~_.-__--_- _--
(Btat whether ~roylnd, root, Wall, projecting, banner, special, stc.j
Weight~~. '~ __.Material o! construction_1~.L1`.~r,L_.[~_.~_1~~...~__ ~_r2_.~_G__z,E,~r-_,,e~1~1 ~-_.__
Illuminated?_..~ Type illumination_________.11~~?~z- _..~
.Z: ~_.__--________-_-_.....-____-
-~- (State whether Lamps or Neon)
Will sign be over public gropgrty?-_~~--- -----_.-----_---_°---_._.___--____-~
SUBMIT DRAWING IN DUPLICATE SHOWING CONSTKUCTION OF SIGN. AND METHOD OF HANGING
WRITE ADDITIONAL INFORMA'PION BELOW
(For canvas awnings provide dim. ensioned drawing on reverse. side)
~,PORTANT NpTICE:
In consideration of permit given for doing the work ~ described in the above statement, we hereby agree to perform
said tivork in accordance with the attached .plans and specifications, which are a part hereof, and in accordance with Ella
building regulations of the To n oArtlanti.--~o+6C-.~T
Signature o! Builde[~ .t~~~~`' AddressAZ2.~~ ~ _-~ Phone No,F~_'=?X~..l
.Signature o! Owner__ __- _ -_ Address~__-__-_ ____. Fhone No.-___
DEPART1~xFNT GF BUILDING -'
TOWN OF A'~"i.ANTIC BEACH, FLORIDA
Application for Permit for
Miscellaneous Alterations,
and Repairs
FOR OFFICE USE ONLY
Date. ____.__..-~, 195_-
Permit No:__.__._ __-..-_ 'Fee $
Valuation $_.._~_ ~__~-__~__-
xouse No. _________-_______Y ____
--.---_--_-_-_-_____~._-- ~~1 ____~ ia~a--
To the Supervisor of Building:
The undersigned hereby applies for permit_~ ~ ~7L~~Z_-__...~ f-C?--.t~---._.----_---------------_-_ _~____ ~
(State fG to repair, alter, add to or meve bufldfne: erect awnlna, rign, eta.; install boiler, elevator, etc.)
Building on__.______ _.f_Lot No._-_-__________~__-Block No._-_-_______._______Sub. Div.~___ ____-_ __._.
_(Btate fnctlona! part)
At _ Side No.~~-.~~---.~~_-L~~ ____~__St. Between__- _..._~_._____ancL----~-----~____. Sta.
Valuation $-__~4 ~ O ~ __~_.._ ~k~'RS__.~,_i~s~.sl Q_ - -----_-_-_---_-_--_-------_---
(3tate cost of Imyrovement) ~--- ~_ -_^-~--~
~- - - ---
What is p e
I! resident
Iiow many
If business,
What pluml
Size of pres
Number of ;
Material o!
BUII.DINGS AN'D ANCY
nt use of building-- 'dentfal or Business?.__._..-_ .____-_______~_____.___
what type-Dwelling, arage Apartment, Apartmen or Rooming House?__..
milies accommodated n w?_..~.. _.. __._______.H w many when altered?
hat type?.~_~_._.____ _.___..____.-.____.__ __.__Wi food be prepared for
e work to be done? ....................................................._--- -----
lding_... _-. ._._ Size of extension__
now ...............................................alter aitered....T-__-_
tt building _-_.._ __________ Material of
NECESSARY PLA IN DUPLICATE TO BE
OII. T~JRNER OA GASOLINE
Name of 011 Burn r or tiaeoline Pump ................._......................._-- ---------
Name and Address t Manufacturer _.__._~___.-.
In connection here th, application fs also mad to irlrstall:-_____________
(How many)
made by of __________._ wage metal
(Nwme )danulactutw~) ( nder or above)
_ ._.~.o# building. or_-~._~
(Inelde or ldde) __ (Name of
capacity tank (a)
02
on premises?
Size of iot,_.._
Type or
DRAWING SHOWING ENTIRE LAYOUT ON REVERSI~ SIDE OF THIB
S InG N 3
Size_~~~ ~ _ Classification-..-_ _ _lc.~.CLLI..LZ~_____-____.-----------..-____----
~(State whether ground, root, wall, prolectlnr, banner, speclai, etc,)
Weighty ~~- __.Material of conatruction_(_-3.1~LPr. ~~U_./1L~._d~Z~~..Z`_J_r1~~.~?/_________-_.~___________.
Illuminated? ~-...~f____~___ _ Type illumination__-_-----__----~.~`.GF,/_~_'~ ..-___.------.___--
(State whether Lampe or Neon) `~^~~
Will sign be over Public prop@rtY?------------ --------------_--_--------------------------- -
SUBMIT DRAWING. IN DUPLICATE SHOWING CON ST)IUCTION OF SIGN AND METHOD OF HANGING
W14ITE ADDTITONAL INFORMATION BELOW
(For canvas awnings provide dimensioned drawing on reverse side)
IMPORTANT NOTICE:
In consideration of permit given far doi
said work in accordance with the attached
building regulations of tie Town of Atlantic
;iSignature of
`S3~nature of irlurner
the work as described in the above statement, we hereby agree to perform
ns afnd~sp_ecifications, which are a part hereof, and in accordance with the
~~~.°Addressc`a~.2.~ 1`A~'~`~__s~~ Phone No.~~
Asl~cess..._.,...,,.__..::. _ _ Phone No.
~~
y :~
__.
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