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Permit 324-326 Plaza (vault folder) CITY OF ATLANTIC BEACH, FLORIDA Approved by w Pp4ICATION FOR ELECTRICAL PIRMIT ^ TO THE CHIEF ELECTRICAL INSPECTOR: DATE: J 14 17 IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. JOURNEXM ELECTRICAL FIRM: MASTER EdaRrmAk NE ADDRESS; �. AM BLDG.SIZE BETWEEN; RES.( i APT.( ) COMM.t }' PUBLIC t 1 INDUS. ( ! NEW( l OLD 1 i REW.l ) ADDITION ( l TRAILER I 1 TEMP.t } SIGNS ( ) SO.FT. SERVICE. NEW( ! INCREASE JAREPAIR( ) FEE QR SIZE AMPS 10 Q COPPER ALUM. SWITCH OR BR AKER PH W 'T RACEWAY EXIST.SERV.SIZE PH 3 W VOLT RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED` OPEN TOTAL RECEPTACLES CONCEALED RPEN-41 TOTAL 0.30 AMPS, 3t-100 AMPS SWITCHES NCANDESCEl , FLUORESCENT,&M.V. FIXED 0.100 AMPS. OYER APPLIANCESBELL TRANSF. AIR H.P.RATING " H.P.RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS EIL HEAT; KW-HEAT 0.1 OVER MQTORS H.P. VOLTAGE PHS NO. 1 LP. ' VOLTAGE PHS s a ^. 'Aa.td � r� .� �r.�• MISCELLANEOUS row�ueenoiucQc. i Iuwnsm sim v Jill, OVER SIXI V. CITY OF ATLANTIC BEACH, FLORIDA APPrgWd by APPLICATION EOR ELIRCTRICAL PIRMIT ] 7 TO THE C141EF ELECTRICAL INSPECTOR. DATE; IMPORTANT NOTICE: THE IN CONSIDERATION OF PERMIT, GIVE N FOR _DOING;THE. WORK AS DESCRIBED INLANS AND SPECIFICATIONS HEREBY AGREE TO PERFORM SAID)WO COR ACCORDANCE WITH YHEIELECTRICAL REGULATIONS, CODES AND CITY OF WHICH ATLANTIC BEACH ORDINANCRE A PART ES D ICIAN ELECTRICAL FIRM: MAST R E E (� RFD BOX-- NAME J t t� 1 ADDRESS: psfif BETWEEN: BLDG.SIZE PUBLIC t ) INDUS. NEW OLD:t ) REW t ) RES.( ) APT.I ) comm.( ) t ) '( ) ADDITION l ) TRAILER ! ) TEMP.( ) SIGNS i ) so.PT. �y. FEE` INCREASE REPAIR t i SERVICE: NEW l ) ALUM. CpNpUCTQR SIZE AMPS COPPER TCH OR BREAK PH W ER5l T RCE . Y PH VOLT RACEWAY EXIST.SERV.SIZE FEEDERS NO. SIZE NO, SIZE NO. SIZE OPEN TOTAL LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED ar.raa LAMPS• o.SO AMPS. SWITCHES INCANDESCENT FLUORESCENT&M.V. ---- FIXED o.roa LAMPS. OVER BELL TRANSF. APPLIANCES " H.P.RA'T'ING AIR H.P.RATING OTHER MOTORS AMPS EIL HEAT: KW-MEAT CONDITIONING CAMP.MOTOR OVER •� *t e� H.P, VOLTAGE PHS NO. I NAVOLTAGE PHS. *::^+'kS 43,a, aif f n[S MI ELLANEOUS __�,..... OVER300 V. CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road-Atlantic Beach, FL 32233-Tel: 247-5826- Fax: 247-5877 PLUMBING PERMIT T PERMIT INFORl411AT19N LOCATE ?N#NFORMATION Permit Number: 21891 Address: 326 PLAZA DRIVE Permit Typer- AJMBING- - ATLANTIC BEACH, FLORIDA 32233 Class of Work: RIGATIO.NIDRAINAGE Township: 0 Range: 0 Book: FA Proposed Use: SINGLE MILY Lot(s): Block: Section:0 Square Feet: Subdivision: Est.Value: Parcel Number: _ Improv. Cost: - ---- O . ER INFORMATION - - Date Issued: 5/03/2001 Name: IRVING CORNWELL Total Fees: 885.00 Address: 326 PLAZA DRIVE Amount Paid: 885.00 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 5/03/2001 Phone: (904)249-9680 Work Desc: WATER TAP/CROSS CONNECTION APPLIC,ATION FRES WATER METER/TAP 525.00 CROSS CONNECTION 35.00 CAPITAL IMPROVE. 325.00 tri cztions Re FINAL NOTICE- INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION 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 CONSTRUCTION LIEN LAW CAN RESULT IN THE PR PERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISS(otd ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR,Y10LATION OF APPLICABLE PROVISIONS OF LAW. 7,1 AT B CH BUILDING DEPT. = 6' " CITY OF'ATLANTIC BE,A.CH v APPLICATION TO MAK, ADDITIONS OR ALTERATION Owner A" C,,e/J45/:�";.�`�'� AddresV�' Architect = ✓ , Addressers, Phone Contractor / Address Phone Contractors License/Certification NLubers Expiration Date Property Address ' f :; ' � Lot # Blcok or Unit Subdivision Valuation of Construction $ S {�' Type of Construction ' Describe Work to be Performed , nt �' •• ` °- Materials to be Used Present Use of Building Proposed Use of Building Flood Zone Dimensions of New Area: MATED GARAGE OR STORAGE CARPORT OR PORCH d, LECK PATIO YES NO Nam. Will there be an increase .in nwber,of units Will there be a decrease in nunber of units? . ' Any additional, plLubing fixtures? Anyt new fireplaces? "• SUMLT TWO COMPLEL7J SETS OF PLANS INCLUDING SITE PIAN. SignatureOWNEtt Date^. Signature OONTRACIUR '; ✓' :" Date , � � •�I S I pi ,�/M � i :Iii i { f '4A) 'Al !{2Ary),e vr�r• ��E'Idti i�rnl.{rt�r�rr, , r,l,. I ! I y r 1 i } t_ r IT� 1 ' l J-4 1 { (T -J oc --- r r 1 e f .i f `fib �..J !� i lN 4 � ��....._ ,....._.�__.,_.W.�..,LL.�. �_,.___�___.,__.._.�___�_,�.._. ,� =,; 4'� rte; ,. i` �1y j + � j I�I _� I E i � � 't � .' �.er r�. .��„! F __ �.. ...- .r s ,. .. �{�- r L.., � f f .... � � � ,4 � _�. \\:� 4 i � _,, ti'}.. � ,I �...w.,�. � �{ t � e� { �'i�1 ', � � ..�.- �-.,_ ��� t � j 1 I, r E ' 0 1 �', E ...,�, s ri-.y„�_� v s e � -w.. _,., ti �N �_ �1 t � _ h ,�`.. ,� y"'� 4 Y^ `. L' ( { l f � '. � € ��4. ' f 4 e._ �.,... �, __�., 1 �r ... f •. �` ��4.. .-. ,- �.. ... r 5 `�,,.� �- � � .._y ;� iF �.: � _ ! � s =fir l i y i ;r a r ; t i i l., I i � � I r � i s CITY OF r�t�°�urtic �'e��i - Tw�caa 716 OCEAN BOULEVARD P.O.BOX 25 �- ATLANTIC BEACH,FLORIDA 32233 TELEPHONE(904)249-2396 May 28, 1987 Mr. I. E. Cornwell 324 Plaza Atlantic Beach, Florida 32233 Dear Mr. Cornwell, We mis-calculated the fee for building permit #8715 issued to you on May 27, 1987. The correct fee should have been $57. 00, therefore the balance due is $28. 50. Please remit payment with the enclosed invoice. We apologize for any inconvenience this error may have caused you. Sincerely, e� Theresa Emery Building Department cc:file PRICE. QUOS APPLICATION FOR WATER AND/OR SEWER TAP r APPLICANT NAME_--- ------------------ MAILING ��—Gly -/CL�i e —�— -------------------- MAILING ADDRESS„_ _ _________ PHONE NUMBER_L C ���� 'Z-=--- DATE_ - y SERVICE REQUESTED_ -� C� SERVICE LOCATION_ Z 7 (� ?1�� C ----------------------------- ------------------------------------------------ DATE SENT TO / DATE RETURNED PUBLIC WOR KS_� '1� ____ TO BUILD. DPT. ---------------- DATE OWNER NOTIFIED--------------------- r jj ; 1000pWORIC1 . ' Atlantic Beach JURISDICTION OFFICE OF BUILDING OFFICIAL This building has been inspected and a General Construction NO PERMIT ISSUED ❑ Concrete, Masonry and Finish Cement Work ❑ Lathing ❑ Plastering ❑ Elevators ❑ Plumbing ❑ Mechanical Work ❑ Electric Wiring ❑ Gas Piping 1S NOT ACCEPTED Please correct as noted below before any further work is done. -- DATE Jay, 4, 1987 Don C. Ford Date Inspector Do Not Romovo This Notice DETACH and Bring this Portion of Card With You. Location: 324 Plazat.'Driye_ Date Mar 4 1987 Atlnnt;r Reach JURISDICTION FORM 400.7 -Don C. Ford_ B-9 INSPECTOR STOP WORK Atlantic Beach JURISDICTION OFFICE OF BUILDING OFFICIAL NOTICE This building has been inspected and X General Construction PERMIT FEE DUE ❑ Concrete, Masonry and Finish Cement Work ❑ Lathing . ❑ Plastering ❑ Elevators ❑ Plumbing ❑ Mechanical Work ❑ Electric Wiring ❑ Gas Piping IS NOT ACCEPTED Please correct as noted below before any further work is done. - NOTE - June 8, 1987 Don C. Ford Date Do Not Remove This Notice . inspector ------------------------------------------ DETACH and Bring this Portion of Card With You Location: 324 plaza Date June 8, 1987 Atlantic Beach ISD! 7 INSPECTOR 26903 nEOAOERFROM QUALITY DUSINESS njnms.JNc t99/2965652 w...._._ CITY OF ATLANTIC BEACH No. 4592 FLORIDA Ha 28 NAME I-E—Cerntieil ADDRESS 2652 St Ate Highway 13 CITY Green Cove Springs 32043 Balance owed on mis-calaulated building permit #8715 $28.50 324 Plaza Atlantic Beach 32233 P A I. D JUN 111987 1` 4 When Signed, Dated and Numbered, This Becomes an Official Receipt MAKE CHECKS PAYABLE TO Received Payment CITY OF ATLANTIC BEACH, FLORIDA TREASURER 4 DEPARTMENT OF BUILDING 8715 f CITY OF ATLANTIC BEACH,FLORIDA PERMIT NO.r, PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB P0,50 T Date May 22 19 87 !-11,1•5DrKT l 9134 lit 5/27/6 Valuation$ 4:279.50 Fee$ 28.50 13715 •MCA 9134 I A /P,7/El This permit not valid until above fee has been paid to City Treasurer,and is 10001 subject to revocation for violation of applicable provisions of law. I This is to certify that I.E.GOrnwell has permission to build glass enclosure over existing decka.s rter plans Classification ReSidemial Zone Owned by I.E.Cornwel l Lot 11 Block 10 Slantic Beach i House No. 324 Plsot>ta ! According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE -� 4---1 0 Building material, rubbish and debris i from this work must not be placed in public space, and must be cleared up anc h uled away by either con- '� ",aTner., Building Official. i I� FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER I PLUMBING ELECTRICAL SEWER WATER AM Address• 5,;2�' / heated Square Footage D @ $ SO per sq ft. = Garage/Shed @ $ per sq £t Carport/Porch @ $ j per sq ft = $ 72 ,5 Deck $ Per sq ft = $ Patio @ $ ' per sq ft = $ TOTAL VALUATION: $ Tota ' aluation 1st $ DOv.D Rara&der Valuation 3 iD er thousand or ortionthereof --------------------------------------------portion I Total Building Fee $ (� Q ADDITIONAL PMUTS and/or F = ,S REQUIRED -----�-- + k Filing Fee $ Mechanical , ' Fireplaces @ 15.00 $ Plumbing BUILDINGiPERMIT FEE $ 03 •�y Electric/New -------------- ----- -------------------------- Electric/Tapp - Septic Tank BUILDING PERMIT $ Well WATER METER CHARGE $ &m* ming Pool SEWER IMPACT FEE $ Sign WATER IMPACT FEE $ Water Connection MISCELLANEOUS $ Sewer Connection $ Water Meter $ Elevation Certificate' GRAND TOTAL DUE - - `------------------------------- --- ' ----- T -- ----------- CALCULATIONSand/orNOTES � � ` c CITY OF /*&atic Veda - 9&uz a 800 SEMINOLE ROAD -_----_-----_-------.-_-.--- -- ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE(904)247-5800 FAX(904)247-5805 SUNCOM 852-5800 May 21, 1996 Mary L. Cornwell 2652 State Road #13 Switzerland, FL 32259 Dear Mr. Cornwell: Our records indicate that you are the owner of the following property in the City of Atlantic Beach, Florida: 324 Plaza Drive a/k/a Lot 11, Block 10, Alantic Beach RE#169959-0000 Investigation of this property discloses that I have found and determined that a public nuisance exists thereon so as to constitute a violation of City of Atlantic Beach Ordinance Section 17-8, i.e., Placing signs on trees, posts, fences, etc. You are hereby notified that unless the condition above described is remedied within one (1) day from the date of your receipt of this notice this case will be turned over to the Code Enforcement Board. Under Florida Statute 162.09, the Code Enforcement Board may impose fines of up to $250.00 per day for a first violation and $500.00 per day for a repeat violation. Sincerely, r arl W. Grunewald Code Enforcement Officer KWG/pah cc: Public Safety Director VIA CERTIFIED MAIL RETURN RECEIPT REQUESTED nterototoei ce M E M Q R A N D U M to: Karl Grunewald Code Inforcement Officer cc: from: 1 C SMITH re: Inspection of code violations date: 1/29/95 I was contacted by Yvonne Merritt which was renting an apartment at 324 Plaza Drive(lower) apt.1 and she was concerned about the safety of the residence. Upon inspection I found several items: (1) No smoke detector present (2) Fire extinguisher not certified and tagged. (101b ABC ext.present) (3) Gas heater determined to be unsafe by Vision gas. Note that the tenants vacated the property due to no heal and no smoke detectors. I would like you to look into this situation if you think that it violates city ordinances. from the desk of.. Yvonne Merritt 992-9142 (call to schedule appt.) IC$NTH lieutenant Atlantic Duch fire Racue Landlord— Mary Gornwell 850kmincleRoad Atlantic Duch, Florida 32233 (904)249.3173 fax (904)249-1566 ATLANTIC BEACH FIRE DEPARTMENT DWELLING SURVEY Q9a- 'Ad 3a q p Name: Address: Date: 9 Shift: ❑i�If not at home check here This copy Is used in duplicate ❑ Refused admittance With your consent, the undersigned member of the local Fire Department has just completed a fire safety survey of your home. Your cooperation in eliminating or otherwise correcting the common hazards which he has checked below,will make YOUR home a safer place in which to live, and help us reduce the terrific annual toll of life and property by fire. The Firefighter has been instructed to explain each of the hazards found In your home and you are asked to phone the Fire Department should you need further advice or assistance. IF THE FIREFIGHTER HAS CHECKED NONE OF THE FOLLOWING ITEMS,YOU ARE TO BE COMPLIMENTED ON YOUR PERSONAL FIRE PREVENTION EFFORTS. ❑ Rubbish not properly taken care of ❑ Flammable liquids not properly stored ❑ Combustibles too close to stoves ❑ Unsafe wiring ❑ Roofing In danger of sparks ❑ Accumulations of paper/fumiture ❑ Tall grass too now buildings ❑ Oily rags/mops not properly stored ❑ Stoves not property installed ❑ Fuse box over fused ❑ Extension cord wiring, excessive defective ❑ Garage/sheds In bad order ❑ Paints not properly stored ❑ Unvented hot water tanks Smoke detector not present ❑ Battery needs service (smoke detector) Remarks: r iAi 1 W KNOW WHAT TO DO IN CASE OF A FIRE IN YOUR HOME 1. Plan your escape route from your home or room NOWT 2. Know how to report a fire THINK. . . PREVENT FIRESI SAVE A LIFEI DO NOT SMOKE IN BED. For additional Information call 249-5606 ABFD A CITY OF j*e4atic t;e d - 5'&,r4& 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE(904)247-5800 FAX(904)247-5805 Date s - 2 `n ( Dear Property Owner: The costs to connect your building to the City sewer and/or water system are as follows : Sewer Tap - Labor and Materials to tap into sewer main $ Water Tap - Labor and Materials to tap into water main Water Meter .- Cost of Meter $ — Cross Connection Inspection - Inspection by Public Works to ensure backflow prevention $ •3 S Sewer Impact Fees - Funds future expansion Ca of the sewer plant $ Water Impact Fee - Funds future expansion of the water plant $ Capital Improvement - Funds for improvements , expansion or replacement to water system $ TOTAL COSTS $ 8 If you have any questions concerning these charges please call the building department at 247-5826 . Sincerely, Don C . Ford Building Official DCF/pah DAT5 - E : -------------- PR.E-SERVICE DIVISION JACKSONVILLE ELECTRIC AUTHORITY 233 WEST DUVAL, STREET JACKSONVILLE, FLORIDA 3220 THE FOLLOWING FIi`tAL INSPECTIONt S ) HAVE BEEN ?LADE AND ARE SATISFACTORY : 1 -0— ---� -- --------- ------- --- ---------- = �- --- ------- ------ ------------------------------------------------- ------ ------------------------------ ------------------- ------ ------------------------------------------ ------- Enclosed are the blue copies of the permits. RELY, BUILDING INSPECTION DIVISION cc : FILE t-F F_'.c2 N a CO_D . 106.6—FOUNDATION PERMITS When application for permit to erect or enlarge a building has been filed and pending issuance of such permit, the Building Official may, at his dis- cretion, issue a special permit for the foundations of such building. The holder of such a special permit shall proceed at his own risk and without assurance that a permit for the superstructure will be granted. SECTION 107—FEES 107.1—GENERAL A permit shall not be issued until the fees prescribed in this section shall have been paid. Nor shall an amendment to a permit be approved until the 17 additional fee, if any, due to an increase in the estimated cost of the build- ing or structure, shall have been paid. 107.2—FAILURE TO OBTAIN A PERMIT (a) If any person commences any work on a building or structure before obtaining the necessary permit from the applicable governing body, he shall be subject to the penalty prescribed herein. (b) Where construction is commenced before a permit is obtained, the permit fees shall be doubled. 107.3—ACCURATE RECORDS _�Building Official shall keep a permanent and accurate accounting of aT[peit fees and other monies collected, the names of all persons upon ___<4ccount the same was paid, the date and amount thereof. 107.4—SCHEDULE OF PERMIT FEES On all buildings, structures or alterations requiring a building permit, as set forth in Section 105, a fee for each building permit shall be paid as required at the time of filing application, in accordance with the schedule as established by the authority having jurisdiction. (See Appendix "K" for recommended fee schedules.) 107.5—BUILDING PERMIT VALUATIONS If, in the opinion of the Building Official, the valuation of building, rJJ alteration, or structure appears to be underestimated on the application, permit shall be denied, unless the applicant can show detailed estimated cost to meet the approval of the Building Official. Permit valuations shall include total cost, such as plumbing, electrical, mechanical equipment and other systems. SECTION 108—INSPECTIONS 108.1—INSPECTIONS—GENERAL (a) Before issuing a permit the Building Official may examine or cause to be examined any building for which an application has been received for permit to enlarge, alter, repair, move, demolish, or change the occupancy thereof. He shall inspect all buildings and structures, from time to time, 1-9 CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road-Atlantic Beach, FL 32233-Tel: 247-5826- Fax: 247-5877 PLUMBING PERMIT PERMIT INFORMATION LOCATION INF RM TION Permit Number: 21891 Address: 326 PLAZA DRIVE Permit Type: PLUMBING ATLANTIC BEACH, FLORIDA 32233 Class of WorkL_lR 3.iGATlO1�IX9RAINAGE Township: 0 Range: 0 Book: Proposed Use: INGLE FAMILY Lot(s): Block: Section:0 Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: O INl~fttAYtON - - Date Issued: 5/03/2001 Name. IRVING CORNWELL Total Fees: 885.00 Address: 326 PLAZA DRIVE Amount Paid: 885.00 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 5/03/2001 Phone: (904)249-9680 Work Desc: WATER TAP/CROSS CONNECTION CONTtA Td S AP LICRTI N PEES. — - WATER METER/TAP 525.00 CROSS CONNECTION 35.00 M CAPITAL IMPROVE. 325.00 FINAL NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION 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 "FARE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PR ! RTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" e, ISSQED5ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOF V16LATION OF APPLICABLE PROVISIONS OF LAW. AT LA B CH BUILDING DEPT. CITY 4F 4&4 `. BWXt-4". Office of Building Official REQUEST FOR INSPECTION Date Permit No, Time A.M. Received P.M. District No. Job Address Locality Owner's 1 r ntractor �� ��' Bt1lLDING CONCRETE IECTRIC P),UMBIN MECHANICAL Footing ❑ Rough ir,ngd Re Roofing C7 Slab O Temp Pole 0 Top Out E�1 � Heating Lintel ❑ Final 11 Fire Place O Pre Fab READY FOR INSPECTION Mon, L( T es. Wed, Thurs, Friday P.M, A.M. I j C.3 Inspection Made InspectorFinal inspection ca o Occupancy Date CITY OF Office of Building Official R QUEST FOR INSPECTION Date � Permit No. Time A.M. Received PM. ^ Job Ad cality Owner's Name Contractor —_ BUILDING CONCRETE ELECTRICAL P UMBING HANICAL Framing E, Footing E C Rough 0 Air Cond.& C' Re Rooting C Slab C Temp Pole C Top Out C Heating Insulation Lintei ❑ Final C Sewer C Fire Place C Pre Fab READY FOR INSPECTION A.M. Tues. Wed. Thurs, Friday P.M. A.M. PM. ' Final Inspeotio Certificate o ccupancy u Date _ ` City of At\adic Beacfi REPRlNT *** CUSTOMER RECEIPT *** OPER: DSMlTH UC DRAWER; l DAT[: 5/83/81 01 RECEIPT: 0054431 DESCRIPTION QTY AM8(IN[ TP T�: WATER METERS-A.B 1 5525.00 *80 t�K BACKFLOW PREVENT 1 $35.00 *56 CK WATER CAPITAL lM 1 $]25.08 *57 CK TENIKE R DETAIL CK 519 $885.8Q DATE; 5/03/81 TIME: 16:52:12 TOTAL CHECKS $8G5M z 170 696 039 Receipt for Certified Mail No Insurance Coverage Provided Do not use for International Mail rros,.r serroicr _ (See Reverse) pMj Sent to v t Street and N SZ tC/iia / 3 P.(V,State-and _ Code o a n�l) A- Postage � $ 3z E Certified Fee Ui / i J U) Special Delivery Fee a Restricted Delivery Fee Return Receipt Showing to Whom&Date Delivered (L b Return Receipt Showing to Whom, Date,and Addressee's Address TOTAL Postage $ L &Fees Postmark or Date i_ r+. SENDER: t also wish to receive the • Complete items 1 and/or 2 for additional services. • Complste�,3 and 4a•& ., following services (for an extra •'PffM yrr r mercer a�4d lil�irali an'the ravevsa of this form so that we can fee): return this Bard to VQu. • A#pch thr3'fomrto'th jinni o deilyieca,or on the.beck if space 1. gAddressee'S Address '' does ndt pisi�k �.•:;i; , 'ix. • Wrrta" eWan Receipt Requei*,''on the mailpiece below,t,1le article number. 2. F1 Restricted Delivery C *' • The Rett lie t`hvilI show.to whom the article was delivered and the date C C deiiverarl` Consult postmaster for fee. 0 3.. Article Addressed : 4a. Article Number c m Z. 1-7b894, 7zi boa cP l3 4b. Service Type a p ❑Registered C1 Insured RA Certified El COD E LU � ❑ Express Mail ❑ Return Receipt for /+ Merchandise o GDate of Delivery 0 Z 5. Signature(Addressee) 8. Addressee's Address{ tly if requested and fee is paid) C 6. Signature.(Agent) � PS Form 3811,December 1981 *LLS.Wo:l Tta DOMESTIC RETURN RECEIPT ,Z �: fu, - '"