Permits 438 Aquatic Drive BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLANTIC BEACH, FLORIDA 32233
APPLICATION FOR MECHANICAL PERMIT CA.L-IN—NUMBER
IMPORTANT — Applicant to complete all items in sections 1, 11, 111, and IV.
Street Address:.
LOCATION
OF Intersecting Streets: Between
87 1 And o6A) D
BUILDING A
I Sub-divi
11 ID T
11. IDENTIFICATION — io be completed by all applicants.
In consideration of permit given for doing the work as described in the above statement iwe hereby a gree to perform said work in accordance
with the attach_ad plans and specifications which are a part hereof and in accordance w th the Cit of Jacksonville ordinances and standards
of good��practice listed therein. y
Name of Mechanical
Lconfraefor (Print) Contractors
Name of
Property Owner
of Owner Signature of
Ind Agent _—LArchiteef or Engineer I
IIL 694RAL INFORMATION
A, Typoof beefing fuel:
a soctric IS OT14ER CONSTRUCTION BEING DONE ON
THIS BUILDING Olt SITE?
13 Gas—C3 LP 0 Natural E3 Contra[Utility
IF YES. GIVE NUM
(3 (M AER OF.CONSTRUCTION
Off. — SPW4 LL)am PERMIT
IV. MCKANWAL IPU"W TO K INVALLID NATURE OF WORk
(Provide Complete list of componstifs a*bock of this form) 0-IFIesidentlat or E) Commercial
_W�_Nsat 0 SPace 13 Itecessed 13 Central 0 Floor ��New Building
C3 Air Coadfiming: 13 Room 0 Central 0 ExIsting'BUIlding
0 Re
C) Duc� system: metwiel placement of existing system
*ty C I Ai", installation(No system previously Insta"
maximum copecl 2r'INOW
93 &+igorofion 0 Extension or add-on to existing system
coormo tower: capacity 9*-ft Other— Specify
C3 Fire Isprinitlem: Number of hos
C), Gavator 0 Marluff 0 EK41016 (MOWW)
THIS WACI PM OPF= US ONLY
C3. 646400 Pumps —(numbod
13, TOO, (number) Ite"fis
C3 LM c"%imft (number)
0 Un&od pre"Wre
(3, Sells" hmii Approved Deft
V'Othw Specify Permit
!LOT ALL EQUIPMENT
AIR CONDMONING AND REFRIGERAnON EQUEPMENT
249 1%=bor IEY*kft Doeript4oft Modd NumbW CONdtY A"MV11nIff
(TOW
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 08-00000874 Date 7/07/08
Property Address . . . . . . 438 AQUATIC DR
Application type description RESIDENTIAL OTHER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6000
----------------------------------------------------------------------------
Application desc
hardi siding
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
CENTURY 21-JIM RITCHR A TO Z REMODELING & HOME
1511 ATLANTIC BLVD. REPAIR INC.
NEPTUNE BEACH FL 32266 230 VISTA GRANDE DRIVE
PONTE VEDRA BCH FL 32082
----------------------------------------------------------------------------
Permit BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 60 . 00 Plan Check Fee 30 . 00
Issue Date . . . . Valuation . . . . 6000
Expiration Date . . 1/03/09
----------------------------------------------------------------------------
Special Notes and Comments
*2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2004 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE.
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 60 . 00 60 . 00 . 00 . 00
Plan Check Total 30 . 00 30 . 00 . 00 . 00
Grand Total 90 . 00 90 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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L)oc FF,_�Uoo-itji3365,QR BK 14554 Pagei 691.
awl-
Numoer P3ges:
Recorded 06127.'2DO8 at 09:13 AM.
i IM FULLE R CLERK C IRC UIT COURT DUVAL . ........ :wl'.
COUNTY
RECORDING$10.00 ....... -------
ckwm
.-An- "-sm-
EXPIAES-SWWW2,9010
-cl uosdwoql ueaa eSS :LD 90 LO Inr
Page I of I
Print Date:
6/27/2008 9:13:46 AM
Transaction#: 1183453
Receipt#: 1134754 Jim Fuller
Cashier Date: 6/27/2008 Clerk Circuit Court
9:13:38 AM Duval County
(KPEARSON) 330 E. Bay Street Rm 103
Jacksonville, FL 32202
(904)630-2044
Customer I nfonnation Transaction Information Payment Summary
DateReceived: 06/27/2008
Source Code: BEACH
Q Code: BEACH
0 A TO Z REMODELING Over the Total Fees $10.00
230 VISTA GRANDE AVE Return Code:Counter Total Payments $10.00
PONTE VEDRA BEACH, FL 32082 Trans Type: Recording
Agent Ref
Num:
I Payments
r9N $10.00
ERIE CASH
1 Recorded Items
BKJPG: 1455411891 CFN.-24909168365
(WQNOTICE.COMMENCEMENT Date:612 712008 9:13.35 AM
From: CROWDER MICIIAEL
A To.- COMMENCEMENT
INDEXING 2 $0.00
RECORDING $10.001
10 Search Items
10 miscellaneous Items
file.//C:\Program Files\RecordingModule\default.htm 6/27/2008
2 -d *I 16 1 iF21006 uosdwoqi ueea eSS :LO BO LO inr
City of Atlantic Beach -APPLICATION NUMBER
(To be assigned by the Building De partment.)
Building Department
800 Seminole Road
Atlantic Beach, Florida 32233-5445
-5826 - Fax(904)247-5845
Phone(904)247
E-mail: building-dept@coab.us Date routed::.
City web-site: http://www.coab.us f
APPLICATION REVIEW AND TRACKING FORM
nt review required __Y7e_s No
_77 (�, i" -
Property Address: r Building,:, )
Z Z
onin!q
s
r) (M
Applicant: Tf*k 6 J Public Works
-Public Utilities
Proj�'c t Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
rArmy Corps of Engineers
Division of Hotels and Restaurants
10
Division of Alcoholic Beverages and Tobacco
Other:
APPL,16ATION STATUS
Reviewing Department First Review: E(Approved. DDenied.
(Circle one.) Comments:
PLANNING &ZONING
Reviewed by: Date: 6 7-d-7-1L
PUBLIC WORKS
PUBLIC UTILITIES Second Review: FlApproved as revised. F]Denied.
Comments:
PUBLIC SAFETY
FIRE SERVICES
Reviewed by: Date:
Third Review: F�Approved as revised. ElDenied.
Comments:
Reviewed by: Date:
08-1
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD,ATLANTIC BEACH,FIL 32233
OFFICE:(904)247-5826 9 FAX NO.:(904)247-5845
BUILDING-DEPT@COAB.US
DUVAL COUNTY
BUILDING PERMIT APPLICATION
DER
12;
0C)c 13 .1.9
L/3,? AIRLAA—IMC. Atlantic Beach, FL 32233 .7 -Ilaw- -,—-,
S C 'w W, :1:1 e "1,11-el�
b
iF [I NEW BUILDING 0 DEMOLITION RESIDENTAL
LOT"0- 0 CONVERTING USE 0 COMMERCIAL
LOCK SUB DIVISI&T 1:�-eg tk r1X C- CrA",C 0 ADDITION
11 ALTERATION SLIDG..
77T�E�IPTIOWOF WORK, 11 ACCESSORY SLOG.
U REPAIR 0 POOLISPA YES N/A
Ll MOVE V.OTHER NO
ARCHIT
PROPER
TY,OWNER:
9.NAME: 15.COMPANY NAME: 23.COMPANY NAME:
A T-0 aEf-100E-L-rahl- --
M=C.1*AEi- 14. CAoW06E A 16.NAME: 24.LICENSEE NAME:
M4^1-coAl ()&,qtJ 7140MPJC1I)A0
10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.:
c
(3 ( 1i s ILI q
Ll 3 g L4-04-7 1 B.ADDRESS: 26.ADDRESS:
5 1113
#C'L a;?3-0 tp .S AV
r3"4/ V.;aa-
11.OFFI 12.FAX NO.: 19.OFNCE PHONE: 120.FAX N�D.: 27.OFFICE PHON
Ii?(Af-1-73 —'10g4t7o�—�o4i—emy
11 1 PHONE: 211. L PHONE: 26,CELL PHONE:
r. 6 - 113 4 %,4 1(I - 6 ( I X 30.EMAIL ADDRESS:
14.EMAIL ADDRESS: 22.EMAIL ADDRESS:
�-TEE—SIMPLE TITLE HOLDER:
0
BONDING
:C MP
(IF 0
31.NAME: 33.NAME: 35,NAME:
32,ADDRESS: 34.ADDRESS: 36.ADDRESS:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this
jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Fumaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
OWNER'S AFFIDAVIT-I certify that at t e rego ng n rm on is a work will be done in compliance with all applicabl
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE T
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING7 CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEM-E.-Ilk
RAC TO
E ----�'CONT
TA
"Req-
P Z
6 Signed: Date: Sign-el+
in the c not
Z
Before rn da 20dKin the county of Before me thlq�,�day of (-Li,-(- 20 F--
Duval,Stat Florida,has onally p eared Duval,State of Florida,has personally appeared L)
r4\ C U
12- <
ck-a
ments and declarati s
"f I herself and affirms7hiat al s;at ments and declarations are herin by himself/herself and affirms that all state
h
e and te. true and accurate.
unty of
at Large,State of County of N ta' Public at Large,State of 'C.
�Z�'L.nally Known
entification- 13 Produced Identification-
cwwu ' --;Z�
Notary Signature:
Notary S i ure:
0
MIRANDA L TONEY
MIRANDA L TONEY
MY COMMISSION#DD 5HU8
MY COMMISSION#DD 584628
ED: EXPIRES:September 2,2010
OABFO EYMMTSeptember 2,2010 Bonded Thru Nohuy Pubic Undomftem
Borided Thru No"Pubk Undsm*=
M I A M 1-DADE MIAMI-DADE COUNTY,FLORIDA
='M METRO-DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE(BCCO) 140 WEST FLAGLER STREET,SUITE 1603
PRODUCT CONTROL DIVISION MIAMI,FLORIDA 33130-1563
(305)375-2901 FAX(305)375-2908
NOTICE OF ACCEPTANCE (NOA)
James Hardie Building Product,Inc.
10901 Ehn Avenue
Fontana,CA 92337
SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction
materials.The documentation submitted has been reviewed by Miami-Dade County Product Control Division and
accepted by the Board of Rules and Appeals(BORA)to be used in Miami Dade County and other areas where
allowed by the Authority Having Jurisdiction(AHJ).
This NOA shall not be valid after the expiration date stated below. The Miami-Dade CountY Product Control
Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to
have this product or material tested for quality assurance purposes. If this product or material fails to perform in
the accepted manner, the manufacturer will incur the expense of such testing and the AM may immediately
revoke,modify,or suspend the use of such product or material within their jurisdiction. BORA reserves the right
to revoke this acceptance,if it is determined by Miami-Dade County Product Control Division that this product or
material fails to meet the requirements of the applicable building code.
This product is approved as described herein,and has been designed to comply with the Florida Building Code
including the High Velocity Hurricane Zone.
DESCRIPTION:Hardiplank,Cemplank,Hardipanel,Cempanel,Hardisoffit and Cemsoffitt
APPROVAL DOCUMENT:Drawing No.HPNL-8X,HPLK-4X8&HSOFFIT-8X,titled"Hardipanel&
Cempanet;Hardiplank&Cemplank;Hardisoffit&Cemsoffit Installation Details",sheets I through 3 with no
revisions,prepared,signed and sealed by Ronald Ogawa,P.E.,dated 04/02J04,bearing the Mian-�-Dade County
Product Control Renewal stamp with the Notice of Acceptance number and expiration date by the Miami-Dade
County Product Control Division.
MISSILE IMPACT RATING:Large and Small Missile Impact
LABELING:Each unit shall bear a permanent label with the manufacturer's name or logo,city,state and
following statement: "Nliami-Dade County Product Control Approved",unless otherwise noted herein.
RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no
change in the applicable building code negatively affecting the performance of this product.
TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the
materials,use,and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any
product,for sales, advertising or any other purposes shall automatically terminate this NOA.Failure to comply
with any section of this NOA shall be cause for termination and removal of NOA.
ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County, Florida, and followed by
the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall
be done in its entirety.
INSPECTION:A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors
and shall be available for inspection at the job site at the request of the Building Official.
This NOA renews NOA#02-0729.02 and,consists of this page,evidence page as well as approval document
mentioned above.
The submitted documentation was reviewed by Carlos M.Utrera,P.E.
NOA No 07-0418.04
Expiration Date: May 01,2012
in- Approval Date:May 31,2007
1W X Page I
James Hardie Building Products,Inc.
NOTICE OF ACCEPTANCE: EVIDENCE PAGE
A DRAWING(submitted under NOA No.02-0729.02)
Drawing prepared by James Hardie Building Products,Inc-titled"Hardipanel&
Cempanel; Hardiplank&Cemplank;Hardisoffit&Cemsoffit Installation Details",
drawing No BPNL-8X,HPLK-4X8 &HSOFFIT-8X,dated 04102/04,with no revisions,
signed and sealed by R.L. Ogana,PE.
B TEST (submitted under NOA No.02-0729.02)
Laboratory Report Test Date Signature
1. ATI-16423-1 PA 202&203 03/18/96 A. N.Reeves PE.
2. ATI 16423-2 PA 202&203 03/18/96 A.N. Reeves PE.
3. ATI 16423-3 PA 202&203 03/18/96 A. N.Reeves PE.
C QUALITY ASSURANCE
I. Building Code Compliance Office.
D MATERIAL CERTIFICATION (submitted under NOA No.02-0729.02)
1 Standard Compliance (ASTM C-1185)issued by ETL Testing Laboratories on 05/09/95
signed by D. K.Tucker,PE.
2 Evaluation Report NER-405 issued by National Evaluation Service,Inc. on 01/01/93,
with no signature.
E STATEMENT (submitted under NOA No.02-0729.02)
1. No change letter issued by James Hardie Building Products,Inc.issued on 02/16/99,
signed and by J. L Mulder.
2. Power of Attorney and Appointment of Domestic Representative, signed by P. Shafron
on 04417/02,Assignment and Memorandum of Assignment signed by T. P. Dolmans on
04/16/02 and Assignment for the trade marks of Cemplank,Cernpanel and Cemsoffit to
the Assistant Commissioner for Trademarks signed by V.Uster and P. Shafron on
04/18�02.
E OTHERS
I No change letter issued by James Hardie Building Products,Inc. issued on 04/02/07,
signed and sealed by Chad Diercks,Technical Services Manger.
2. Engineer of record letter issued by Ronald Ogawa&Associates, Inc.,dated April 3,
2007, signed and sealed by Ronald 1. Ogawa,P.E.
Carlos M.Utrera,P.E.
roduct Control Examiner
NOA No 07-0418.04
Expiration Date: May 01,2012
Approval Date:May 31,2007
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-————————————
PS"44
11405
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
------ PERMIT INFORMATION ------
-------- LOCATION INFORMAT16N --------
Permit Number , � 11405
Permit Address : 438 AQUATIC DRIVE
Type: PLU14BINO I I ATLANTIC BEACH, FLORIDA 32253
Class of Work; ALTERATION -------_ LROAL DESCRIPTION ---------
Constr. Type: WOOD PRAMZ Lot : Block: Section:
P 6
,r pd,sed Use: SINGLE FAMILY Township: RNG:
' Dwellings: I " Code - 0 0
Subdivision-. AQUATIC GARDENS
Estimated value-, $0.00
Improv. Cost : $0. 00
Total Fees , $25.00
Amo $25.00
'30 , 9�
Work CHANGEOUT
ATION APPLICATION pp.I Es
A -CITY-OF ' PERMIT
res TIC DRIVE WAT , IMPACT PER $O .00 .
CHI PLORWte "�A A;?e*
n _31 7 A ITAP wa
RADON GAS-H.R. S. $0 .00
- ------- NFORMA ON ------- RADON CAB 5% $0 .00
T T
Name* IR A S PLUM$ CAPITAL IMPROVE.
A $0 .00
SEWER T*F
JA ILLE, FL , 32217 CROSS CONNECTION $0 .00
0 SEC H IMPACT FEE
CONST.SURCAARGE $ 00
NOTES:
NOTICE ALL CONCRETE FORMS AND FOOTINGS MVST BE INSPECTED 13EFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE,
13UILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE
CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
S'FAILURE TOCOMPLYIWITH THE MECHA
NIC'S LIEN LAW CAN' RESULT'IN,
THE PROPERTY OWNER PAYING TWICE FOhTHE BU14MNG IMPROVEMENTS
ISSUED�ACCORDING'I 0^t-rmvv.t: PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TOREV60ATioN FOR
V16LATION OF APPLICABLE PROVISIONS OF LAW.
40404" WOOD= 40 'A
'0ate; 1301%01 *Ott
ATLANTIC BEACH BUILDINO 002m,
D.EPA ENT
4,,
i
CITY OF ATLANTIC BEACH
APPLICATION FOR PLUMBING PERMIT
JOB LOCATION:-
OWNER OF PROPERTY:
PLUMBING CONTRACTOR
CONTRACTOR'S ADDRESS:__ _ ,<4
STATE LICENSE NUMBER:-,.
TELEPHONE:
HOW MANY OF THE FOLLOWING FIXTURES INSTALLED
SINKS SHOWERS
LAVATORY ______WATER HEATERS
BATH TUBS DISHWASHERS
-URINALS DISPOSALS
CLOSETS -WASHING MACHINE
FLOOR DRAINS SHOWER PANS
OTHER
TOTAL FIXTURES: x $3 .50 $15 .00
MINIMUM PERMIT FEE $25 . 00
SIGNATURE OF OWNER*
SIGNATURE OF CONTRACTOR:
-----------------------------------------------------------------
INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH
THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE.
CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826
SEWER CONNECTIONS MUST BE CALLED INTO PUBLIC WORKS FOR INSPECTION
PRIOR TO COVERING UP - ( 904) 247-5834
CITY OF AiLANTIC BEACH
ROOFING PERMIT APPLICATION
JOB LOCATtON.—
��o�CCV�TELEPHONE.--
OWNER OF PROPERTY.—I I S 1� -
CONTRACTOR.- ARLINGTON BEACHES ROOFING, INC.
CONTRACTOR'SAODRESS: 1441 CESERY TERRACE
JACKSONVILLE, FLORIDA —ZIP: 32211
STATE LICENSE NUMBER: RC 0023962 TELEPHONE:744-8888
DESCRIBE WORK TO BE PERFORMED� RE–JROOF:
VALUATtON OF PROPOSED CONSTRUCTION
MATERIALS TO BE USED-� k) _S
SIGNATURE OF OWNER,
SIGNATURE OF CONTRA TOR:
SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF
IS 1)A I
KIMBERLIH.GODWIN
AS TO OW
MY COMMISSION#CC 713745
wvch13.20021 NOTAt�
PUOLIC
_)0 Y
SWORNT THIS F
KVIBERLY H.GODWIN
- W
rMISSION#CC 71 3745
OM
IX='
AS TO C TOt OMMISSION#CC 713745
�PMES!Match 13.20021
",tW SA.& rx.ng C. 8LIC
14)00-3-NC'fAFW
SWea&Somfing Co, N(Dr
Liability Insurance Supplied
Workers Compensation Insurance Supplied
Contractor License Information Supplied
OccuPational License Information Supplied
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 Seminole Road -Atlantic Beach, FI 32233 -Tel. (904) 247-5826
ROOFING PERMiT
k:
Square Feet: Su division: AQU I GARDENS on:
Est.Value: Parcel Number:
Improv. Cost: 2,485.00 ---_---OWNER INFORMATION
Date Issued: 5/31/2000 Name: CROWDER, CHRISTINE
Total Fees: 37.50 Address: 438 AQUATIC DRIVE
Amount Paid: 37.50 ATLANTIC BEACH, FL 32233
Date Paid: 5/30/2000 Phone: _(000)000-0000
Work Dese:
C T1_R_AC_TbR(!
ON APPLICATION FEES
-AR-LAWNGTON BEACHES ROOFING -PER-M-11�_
37.50
__T_____[#j4ppctIons Required
NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION
BUILDING MATERIAL, RUB131SH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND
MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
"FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY
OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"'
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
CITY 0 *CH
F AT TIC Date: 1,4
CHF(-KR -,j Rccelgt: 85_6_15_4�
011006@3221000 1�722,