Permit 1861 Park Terrace E (vault) F SUlILDING
ART11AFENT 0
C iTy OF ATLANTIC BEACH
--------- LOCATION' INFORNATION
OERrIT IMPORIIATION -7--
t JB61 PARK TVRRACE rA-j T
5123, Addre6s RIDA 32233
P rsit 'Huy4beri, ATLANTIC BEAC14p, FLO
-----------
pejuit Ty. ---------- iLEGAL DESCRIPTION
NEW
asg of ,, or '. Lot: 01cw-k t
WOOD FRA"E RNG.- 0
Con
str.' Typ Township'
SINGLE FAHILY
'Proposed. 'Use,I Subdivision:
0
Code t
$0.00
Estisated Value:
$0.00
Cost:
$22.150
Total,
Amou
20-YEAR
ASS� SHINGLES
H ME FIBEROL
APPLICATION FEES
AZION ry PERXIT
--------- $22. 50
HA" $0,00
T I"PACT FEE,ew
TERRACE-
A�idr` ""00, r- I
H, FLORI "al 11
4 00.00
P RADON GAS-H. R. S-
$0.00
RADON GAS 5%
0 FORHATf ------1- $0.00
WATER TAP
c) i RACtIMc30i";;§A4- SEWER ti $0.00
HARE $0.00
"YDOAULic S
00
FL 32217
- N EE
JACK L RE-i SPECT F,
0
�4 Type: 0 g4 *10."Q
EC; H 1APACT FEE, ' 0
Lic
S
A------------ 21se"W", w,
NOTES:
E INSPECTED 13EFORE POURING,
NO-TICE ALL CONCOETE FORMS AND FOOTINGS MUST 6
PERMIT VOID SIX MONTHS AFTER DATE,OF ISSUE
OT Ot PLACED IN PUBLIC SPACE,AND MUST BE
S FROM TRIS WORK MUST N,
SUILDING-MATEIRIAL
4�UPL?tlollllgH AND DEB1,RI
AWAY 13Y EITHER CONTRACTOR OR OWNER
CLEARED UP AND
ULT IN
'141PLY WITH THE MF-C-HANICS'9 LIEN LAW CAN, RES
To Co
ROPER
PAYI' A SOL G PRO
NG TWICE FO DIN-1 '11YI VEMEN 9 TS.
WE P - WN
ift$ WIWI
ERMIT AND SUSj��TO REVWI�M I
RT OF THIS P
LANS,WHICH ARE PA
RDING,10.APPROVED,P
ISSUED AC60 RD $&50,,
VAOL ICA k, $IONS OF LAW.
ATION OF�APPL 0 E'PROVI
BUILDING DEPARTMENT
07,77
CITY OF ATLANTIC BEACH
PERMIT APPLICATION ROOFING
Owner(s): 17el-
Address: / re AkV 4 e-
Phone:
Lot # Block or Unit # Subdivision
Contractor:
Address:-,237-,�' Phone:--- '7T z ",7
State License No.
Describe work to be done:
Materials to be used:—
Signature OWNER: ' Date:
Signature CONTRACTOR: