Permit 871 Ocean Boulevard 000490
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
----- PERMIT INFORMATION ------ -------- LOCATION INFORMATION ---------
Permit Number: 496 Address: 871 OCEAN BOULEVARD
Permit Type: ELECTRICAL ATLANTIC BEACH, FLORIDA 32233
Class of Work: NEW ---------- LEGAL DESCRIPTION ----------
Constr. Type% N/A Lot: Block: Section:
Proposed Use% SINGLE FAMILY Plat Book: Page: O
Dwellings: O Code: O Subdivision: A
Estimated Value: $0. 00 ---------- OWNER INFORMATION ----------
Improv. Cost: $0. 00 Name: FRED CARLSON (BUILDER)
Total Fees: $0. 00 Address: 871 OCEAN BOULEVARD
Amount Paid; $0. 00 ATLANTIC BEACH, FLORIDA 32233
Dater Paid Phone:
Work Dentes. : 2OOAMPS, IPH, 3W, 230VOLT; COURTESY PERMIT/VACANT FOR ONE YEAR
------ CONTRACTOR(S) -------- ---- APPLICATION FEES -----
PERMIT $0. 00
WATER IMPACT FEE $0. 00
SEWER IMPACT FEE $0. 00
WATER METER $0. 00
RADON 'GAS-H. R.S. $0. 00
RADON GAS - 5% $0. 00
WATER TAP $0. 00
SEWER TAP $0. 00
HYDRAULIC SHARE $0. 00
RE-INSPECT FEE $0. 00
ENGINEERING $0. 00
OTHER $0. 00
NOTES:
NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
BUILDING 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.
"FAILURE TO COMPLY WITH THE MECHANICS' 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.
ATLANTI BUILDING DEPARTMENT
B JOB COPY
000496
f DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
PERMIT INFORMATION _ __. .n - -- -- -- -- LOCATION INFORMATION
Permit Number : 496 Address; 871 OCEAN BOULEVARD
Permit Type: ELECTRICAL ATLANTIC BEACH, FLORIDA 32233
Class of Work: NEW _... ._._ _.__ LEGAL DESCRIPTION
Constr. Type: N/A Lot : Block- Section:
Proposed Use: SINGLE FAMILY flat Boris: Page: 0
Dwellings: O Code: 0 Subdivision : A
Estimated Value: $0. 00 _... ___ _ _._- OWNER INFORMATION
Improv. Cost: !90. 00 Name: FRED CARL SON ( BUILDER)
Total Fees;; $0. 00 Address. 871 OCEAN BOULEVARD
Amount Paid $0. 00 ATLANTIC BEACH, FLORIDA :32233
Dat. '" .d Phone: t )
Work Desc. s 2OOAMPSc, 1PH, 3W, 23OVOLT; COURTESY PERMIT/VACANT FOR ONE YEAR
__..._: CONTRACTGR<S) ------- - _ - APPLICATION FEES
PERMIT lio. 00
€ WATER IMPACT FEE $0. 00
SEWER IMPACT FEE $0. 00
WATER METER $0. 00 =;
RADON 'GAS-H. R. S. $0. 00
RADON GAS ._. 5% $0. 00
WATER TAP $0. 00
SEWER TAP $0. 00
HYDRAULIC SHARE $0. 00
RE- INSPECT FEE $0. 00
ENGINEERING $0. 00'
OTHER $0. 00
NOTES:
E
NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
i
BUILDING 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.
"FAILURE TO COMPLY WITH THE MECHANICS' 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.
ATLANTIC BUILDING DEPARTMENT
i
By CONTRACTOR CbPY
'gs i �7s CITY OF
4&404.0 /e�4&404.0 /3
C eack- V&U- 4
Office of Building Official
REQUEST FOR INSPECTION /jam
Date_ Permit No. 1F'
Time A.M.
Received P.M. District No.
3-71
Job Address Locality
Owner's
Name Contractor lb _
BUILDING CONCRETE ELECTRICAL PLUMBI G MECHANICAL
Framing ❑ Footing ❑ Rough Wiring ❑ Rough ❑ Air.Cond.& Cl
Re Roofing ❑ Slab 11 Teo
le f, Out ❑ Heating
Lintel 11 <"' '/l��// Fire Place ❑
Pre Fab
READ OR INSPECTION
Mon. Tues. Wed. 22 Thurs. Friday P.
Inspection Made — � ?7 P.M.
Inspector Final Inspection❑
Certificate of Occupancy
Date