409 Sailfish Dr (vault) 34/77
CITY OF ALIANTIC BEACH
COMPLAINT MANAGHMENT .;Y.c;TF:M
17 1994
' AI(EN (date/time) AY11-7
11124
— 14 r n d Z
cOMPLAINANT: uoildingr a
ADDRESS: Last Wame— Vjrs-t Name
CITY/STATi�/Zjp: t�—J-77/7—
Al-/-X, -0c.-
TELEPHONE:
COMPLAINT:
L
cz
LOCATION: Z-Ad
PROPERTY OWNERS P'HON E
r"'OPERTY OWNERS NAME:
DFPARTMENT FORWARDED TO:
('011HAINT TAKEN BY: DATE/TIME:
OFFICE USE ON
rNVESTIGATED: (date/time) z—/-
ASSIGNED DEPT./DIVIsIoN:
rNVESTIGATOR: --- PRIORITY:--- --
CONDITIONS FOUND:
CTION TAKEN:
d&!'f'4
Oda
OPIPLrANCE:
fj�TES:
F—
HEATING - FURNACES, BOILERS, FIREPLACES
A�
Number Units Description Model Number
#10 y Id,
mww many NowbAd cvwty No 0 of . serial A Yin
P=am Dinunslons =ta= No. y
CITY OF ATLANTIC B�ACHI FLORIDA
by APPLICATION FOR ELECTRICAL PERMIT
DATE:___z 19
�//TD THE CHIEF ELECTRICAL INSPECTOR:
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING TH:. WORK AS DESCRIBED IN THE FOLLOWING, WE
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE I IITH THE ATTACHED PLANS AND SPECIFICATIONS,
WHICH ARE A PART HEREOF, AND IN'ACCORDANCE WITH THE ELECTRICAL REGULATIONS. CODES AND CITY OF
ATLANTIC BEACH ORDINANCES.
_h Z"'dc
MASTER ELEal� RE
AME -ADDRESS: RFQ______BOX
BLDQ-SIZE BETWEEWAI/1- LEI &J
RESA-f- APT.( I COMM- PUBLIC INDUS. NEW I OLD "EW.( I
ADDITION TRAILER ( TEMPA I SIGNS SO.FT.
69RVICE: NEW INCREASE(vf' REPAIR FEE
i2NDUCTOR SIZE 41-e-) AMPS ;2-CC, COPPER ALUM.I Ll-
AMPS
i"MTCH OR-BREAKER V 0 L -- Z PH W _2 31,,�VO 567L RACEWAY
XIST.SERV.SIZE AMPS PH W Z-5�) VOLT , 5767C-RACEWAY
i fEEDERS__ NO. SIZE INO. SIZE NO. SIZE
,LIGHTING OUTLETS CONCEALED OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
0,30 AMPS. 31.100 AMPrl.
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED ' 0A00AMPS. OVER BELL TRANSF.7
APPLIANCES
IR H.P. RATING H.P. RATING
ONDITIONING COMP.MOTOR OTHER MOTORS J NIPS CEiL HEAT:' KW-HEAT
14 /"<4/
T_ OVER
0-1 1 H.P. VOLTAGE PHS1
IMOTORS H.P. I VOLTAGE PHS NO.
!TI'SCELIANEOUS
TRANSFORMERS: UNDER 600 V. OV E R 600 V.
i NO. KVA NO.1 lKVA
NO.NEON TRANSF. NO. VA. MA. )R SIZE SWITCH FLASHE
EACH SIGN
FORWARDED
IS
TOTAL FEES
-4
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH,FLORIDA PERMIT No. 5811
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
Date 2/23/83 19
Val�ation s 4500.00
-Fee s 28-50
This permit not valid until above fee has been paid to City Treasurer,and is
subject to revocation for violation of applicable provisions of law.
This is to certify that BETTY HILL
409 SATIST914 DRIVE
has!permission to tad���e i�ee �la �ound �home
4
LJ
Cla sification VTNQ_9 FAm-IL-y Zone— RS-1.0;g,_
Owned by RRITV 11TT I fl 6 J
Lot' Block S/D_
Hoise No. 409 SAILFISH DRIVE,
A4 rding to approved plans which are part of this permit
NOTICE—ALL CONCRETE
AND FOOTINGS MUST BE IN-
SPECTED BEFORE 1POURING.
PERMIT VOIDSIX MONTHS
AFTER DAT1 OF ISSUE
4— 0 Building material, rubbish and debris
z
-1 from this work m4t not be placed
in public space, and must be cleared
up q -Oled aw0y by either con-
or'owner.
rra c
Building Official.
FOR OFFICE PERMIT
DATE
USE ONLY NUMBER CONTRACTOF
PLUMBING
ELE.CTRICAL
SEWER
WATER
40*� AWK
FOR OFFICE USE ONLY
Date------ ........:21.;��...... ...0-1
Pern it *........................Fee$........................
CITY OF ATLANTIC BEACH Valuation $------------------------------------------------------
FLORIDAHouse #-----------------------------------------------------------
............................................................................
APPLICATION FOR BUILDING PERMIT
...........................................I.................................
............................................................................
Application is hereby-made for the approval of the detailed statement a. the plans and specifications herewith submitted for the
building or other structure described. This application is made in co npliance and conformity with the Building Ordinance of
the City of Atlantic Beach, Florida, and all provisions of the Laws of f.ke State of Florida, all ordinances of the City of Atlantic
Bea(h and all rules and regulations of the Building Department of the (ity of Atlantic Beach, shall be complied with, whether
heren specified or not.
rhe Contractor or Owner-Builder who has been issued a Buildi P is automatically responsible to ascertain that all sub-
ni'� erml
cont actors engaged by him are duly licensed in the City of Atlantic each, Florida. To prevent delay or embarrasment regard-
ing ntermediate or final inspections it is suggested that a list of sub-_�ntractors be submitted to this office so that licenses can
be rifled.
Date.............................C) !A .......
13.......----------------- 19:�
Ow�er--- ---qj_�Z� ----------------_----........ -----_-----------...Address-----� 6�_�sj-—-------Telephone No.............................
A4-tect_-_.--_------i
.......................................... ...................Address,..........................................................Telephone No---------------------_-_-
Coni xactor Builder...... ............----------_-------......Address.... ..............................--------------------Telephone No--------_--_--_----------
LotNo...------------------------------------------------Block No-------_--__--------------Sub Divisioi.......-----------------------------------------------------------------------Zone-------------__
.......................------------------------------_...Street---------------- --------Side Between...._--_---------------------------------------and......................................................Sts.
Valuation $...14!�00Q2......For what purpose will building be used.......... .............................Type of construction.
Dimensions of Building---_----------_...... .........----Dimensions of Lot.-................ ....................................Size of Footings...................... .......
Size of Piers-----___............-----------Size of Sill's------------------ ----------.--Greatest S 11 Span in ft...........................Type Roof.....................................
How will Building be Hpated?...--------------........................... _---_--------Will Building be on Solid or Filled Ground?........................................
Size of Ceiling Joists...............__........................ Distance on Centers...------- __.....__................. Greatest Span-------------------------------------------- of
Size of Floor Joists............................................... Distance on Centers.. ...-. .. ........................, Greatest Span..........................................
Size of Rafters.-....----------------------------- Distance on Centers. ..... ..... ........__...... ...... Greatest Span............................................
APPROVED
This rectangle is to represent the lot.
CITY OF ATI;NTIC BEACH
BUILDING OFFiCE Locate the building or buildings in the
right position. Give distance in feet from
all lot-lines and existing buildings.
2 -0 3 REAR LOT LINE
Tw�copies of plans and specifications shall
be s4bmitted with application.
'nsteion' qs in place and ready to pour foad
1. !n ste:el iuired'
I ns and/or lintel. Z Z
ls in place and ready to pour col
te:l
n:t
3. �bh:n e is in place and ready to pour beam.
4. N rhen framing is completed.
5. N rhen rough plumbing is completed,and ready to cover up.
d.
6. When septic tank drain field or sewer is laid but before it is cover
7. 1 lectrical inspection by City of Jacksor.ville.
8. F inal inspection.
Note: In case of any rejection,re-inspection MUST be called for after
corrections are made.
FRONT OF LOT
In consideration of permit given for doing the work as described hk the above statement, we hereby agree to perform said
worl: In accordance with the attached plans and specifications, whien are a part hereof, and in accordance with the building
reg-c lations of the City of Atlantic Beach.
S,igr ature of Builder................................................................................ Adt as...................................-..............................................................
Sigr,ature of Owner......_........................................................------_----_- Ad ess....................................................................................................
|
| UPTLUING:
_______
[3UlMG:�_ _ _____ _____
GiV{ANTCAl :
| | [L[C[8lCAL:
i
�
. DDlI,DING PERMIT YOR�SB6�I
.......................................................................................................................-
ENT OF BUILDING
CITY OF ATLANTIC BEACH,FL
ORIDA
PERMIT 7-0 BUI PERMIT No. 5516
THIS PERA41T MUST 13E POSTED ON J,:)13
Date
Valuation$
—aZAWL20——19
Fee$
Tb's Permit not valid until above fee ,�O
subject to revoca fias been Paid to C-
of Ity Treasu
'ino for violation applicable provision,of�W.a"
This is to certifY that BE fer, d is
409 SAILFISH DR HILL
has permission to build "'" ATLANTIC BEACH, FLORIAA
Classification ROOM ADDITIon AS PER P SUBMITTED
SINGLE V
AMILy
y BVTT'V
Owned b HILL —'�one S-1
Lot
House No. 4:09 n7
SAILFI.SH,
According - - �'IJ11-1'1 I --,S/D ROYAL p
to
approved pi
'ns which
\TCRETE FORA4S
'TST BE IN-
FOR OF
USE
ll)U I 1,I)I
PLUMBING:
LOT: MECfi,,lN I CAL:
ELECTRICAL:
BUILDING PERMIT WORKSHEETI
1,2
",D SQUARE FOOTAGE: @ $ J per sq. f t-
HEAT�
GARA;E (PRIVATE/SHED) : @ $ per sq. ft.
CARPDRT: @ $ per sq. ft. = $
PORC ES: @ $ per sq. ft. = $
DECK @ $ per sq. ft. = $
@ $ per sq. ft. = $
PATI110:
TOTAL VALUATION:
PERMIT FEES
cP -7. 10. 06 s—
TOTAL VALUATION DATA i s t p a coo
I /,g f ? 7. R6 - 3 $
REM41NDtR VALUATION @ $& .,o0per thousand
or portion thereof
TOTALBUILDING PERMIT FEE. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PLUS 1-2 THE BUILDING PERMIT FOR PLAN FILING FEE. . . . . ... . . . . $
$
TOTAL FEE DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -�lj
----------------------------------------------- -----------------------------------------------
PLU�BING PERMIT FEE; $ MECHANICAL PERMIT FEE: $
ELE I�TRICAL RESIDENTIAL: $ ELECTRICAL TEMPORARY: $
WAT�R METER SIZE: FEE:
SEW i�R CONNECTION CHARGE: SQUARE FOOTAGE: FEE $
WA ER CONNECTION CHARGE: FIXTURE UNITS @ $10.00 PER UNIT: $
ACIOUNT NO. :
TAL BUILDING/PLAN FILING FEES;
T�
APPROVED BY:
T�TAL WATER METER CHARGE:
AF) PROVED TOTAL WATER CONNECTION CHARGE:
CiTY OF ATL0TIC BEACH
BUILDING OFFiCE TOTAL SEWER CONNECTION CHARGE:
K04-3 0 1982 CRAND TOTAL DUE:
',o .-IT
DA'I E
I;Ew TYPF OF !�IJILDING
REP]PE R�_S 11)EINTI AL
ADDI T]ON _CO,'lE_RCI_AL
CAl I ON
AD DRESS
IBING F]RM
.S'l ER PI UXhER
P]EtaSe print
,j-y/COUp TY OCCUPAT10NIAL LICENSE NO.
ATE CK�TIFICATE NO.
11-D-ER C!)R CO'�"TRACTOR
-------------------------------------------- -------------------------------------------
U R I 1111AL S FLOOR DRAINS
'I'l-I's —
LA VA 10 RY BATE TUBS
CI-0 ETS S H 011.E RS I..ATER E��AIERS DISPOSALS
..S 1NG C H I N E OTHER jOTAL F! X-TURE COUNT
�STALLAIJON OF PLIC-2ING A_ND FIXTURES MUST
AC�OP-D-t-_I�CE WITH THE MOST RE-CENT EDITION
I -IBER
S�Ij- ST-' _DARD PL'U-, IB1,'-,'G CODE. SI �,�ATURE OF M_.kS�EER PLIl-,
FIXTURE UNIT �;RF_tj7DOIT�
TS FOR EACH W-VIER FIXfi�RE UNIT
,A OF .:ATFR DLI
.-R-E ESTA-BLISHED AS THE
'STIAll-EI) .-_'�'D CO'�NECTED TO THE CITY 1.,IATT-R SYSIFY1. T-iE I%ATER SUPPLY CHARGE IS h-HREBY FlXED AT
I- D'll \_F --HE C -Y L.'Vi-ER Sl-S- D�- SEC. 27-3 (c)
C._L_�S PER FIXTURE L-NIT CONI CTED TO -i IT
SIWAER SIALL,
"o- GROUP CONSISTING OF BAT TUB (W/OR W/O OVER
'TER CLOSET, 1-,'VATORY & BATH H__A ST-iOWER) (2 b-NITS) Do-'.��STJC (2 uNil,
�IUB OR S!�OWER STA_TL (6 UNITS)
BID�Z' T (3 UNITS) LAU-NDRY TRAY
q0113PINATION SINK & TRAY DENTAL LAVATORY (2 L-,,NlTS)
�,3 UNITS)
i (1 UNIT) KITCHEN SINTY,
O,,BJl','A7JON SINK & TRAY W`1
DENTAL UNIT OR CUSPI- (2 UNITS)
OOD DIS. (4 UNITS) DOR (I UNIT) KITCHEN SINK W/
4Rl'A"-KlNG FOUNTAIN (!� UNIT) DlSffI,ASHEP, (2 UNITS) WASTE GRINDER
OOR DRAINS (I UNIT)
14-YftTerRY (I UNIT) LAVATORY,
I I�AVATORY, SURGEONS (2 UNITS) SHO�NIERS GROUP PER HEAD BEAUTY PARLOR
(2 UNITS)
$URGEONS SINK (3 UNITS) (3 UNITS)
USfllNG RIM SINK (8 UNITS) SERVICE SINK TRAP POT, SCULLERY
STANID (3 UNITS) SINK (4 UNITS)
RINAL, PEDESTAL, SYPHON JET URINAL STALL,
LC-..:OUT (8 UNITS) URJI�IAL, WALL LIP VASBOUT (4 -0;11-
URITNAL TROUGH EACH 21 (4 JINITS)
SECTION (2 UNITS) WASilNG lk�ACHINE RES. WASH SINTK EA SF-.L
(3 JNITS) OF FAUCETS
lJ'A'IER CLOSETS, 7.4-NTK- 1-.IAT z-'R CLOSETS, VALVE (2 UNI TS)
CFERATED (4 UNITS) OPFJ�_41ED (8 UNITS)
_-E C ITS
UTA.L
C ITY OF A TLi'�',;l I r !--- ;-CH
L VA R D
716 OCLAN
A I L A 14 T I C b E fA C p Ft OP. I DA
ADDENDUM 10 BLJILD114G PLAN
Building �ocat ;on:_L-k',
The �ttached plan for the above building is ap roved subject to meeting the follo.4ing
appl cable construction requirements:
a. Footings shall be continuous moriolithic concrete under exterior walls, reinforced
with two 5/8" deformc-d reinforcing rods for one-story buildings and three 5/8"
defori-.,ed reinforcing rods for- two-story buildings. Reinforcing rods shall be
footincs , pioperly placed and f stened on
placed in the lo---wer one-third of the a
- ch side than the
T-ileal cables with wire. Foot- inos �-hall be six inches wider on ed
%.,,all above, shall be at least eight '"Inches thick and sFall rest on firm soil at
least t,�elve inches below undisturbed soil .
b. -.I-n-,-�)ollow,-r.-.asonry- unit—con-struct-ion , each unit cell shall be reinforced %-.rith at
least on No. 4 bar at all conrners, poured and tam'ped with concrete; iuch rein-
forcing shall be properly tied into the footing and s.�;andral beam.
C. 1 All wood truss rafters (roof construction) , shall be securely fastened to the
exterior �-.alls with approved hurricane anchors or clips.
d. Lorstruction of nearby one- family dl,-;ellings , %-.,hich are duplicates or intensely
s i ilarity considers the external conficuration
imilar, shall be avoided- Such simi
and a;�pearcrice (i - e. , 1-00f, outer �-.-all r-,aterials , i-.,-ndow size and design, and
otiner like c�.aracteristics) of structures- In accord with the r1orecoing, sirnnilar
I and shall be at least 500 feet apart if ai), one similar is -visi-ble frorr,
any other simi lar d,,elling-
I - - - ice
e. I The fina-1 connection bet--een the house- pl imbing drain and the se-er �sery
i
connection (at the property line) Piust be inspected by the City before being
icovered-
ity Manager
under � igned hereby certifies that he has read the above and understands that this
endum ',akes precedence over any contrary details to the plans and specifications and
ees to comply with the intent of this addendum.
I 4�4
Contra/FoOo,ner.
Date
FOR OFFICE USE ONLY
Date-----------------------------------19 ....
�r7er C9 C.)
Permit #........................Fee $--_-------------------
CITY OF ATLANTIC BEACH
Valuation $------------------------------------------------------
FLORIDAHouse #-----------------------------------------------------------
.....................................................................
APPLICATION FOR BUILDING PERMIT ..........................................................................
............................................................................
Appqcation is hereby made for the -approval of the detailed statement ofl the plans and specifications herewith submitted for the
building or other structure described. This application is made in co pliance and conformity with the Building Ordinance of
the City of Atlantic Beach, Florida, and all provisions of the Laws of tle State of Florida, all ordinances of the City of Atlantic
Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether
herei[n specified or not.
ihe Contractor or Owner-Builder who has beeu issued a Building Perrint is autonar-tically responsible to ascertain that all sub-
ment ga -
con4actors engaged by him are duly licensed in the City of Atlantic I each,Florida. To prevent delay or embarras re rd
ing intermediate or final inspections it is suggested that a list of sub-ccntractors be submitted to this office so that licenses can
bevorified. Date-----------------------------------------------------------------1 19............
own ......................... ---..-Address.___� .....Telephone No----_----------------------
-----------------
Architect---------- --- ------I----------------- -----Address........------ -------------------------------.......Telephone No-------------------------
2. 4'o----------A.�, _/:�((___Telephone
Contractor Builder - --------------------------.......Address
ya
Lot 0.___1-------- ... ..... .......... ...Block Sub Division-..--------.........___------------------------------------- ..........Zone.................
-----------Street..... ---------- -------- Side Between.-I_-__ _ __ -----------*-----------and......-----------------------------------------------StFl-
Va+tion $............__....... ........For what purpose will building be used--.. -- ---- -------------Type of constructiom....S./ A—-....
Dim�nsions of Building./ -6X'101.4------Dimensions of ----------- .......___...Size of Footings------------_--------------------
size I of Piers......___------- - -- ---------Size of Sills----------- -- . .....Greatest S ill Span in ft---- .......Type Roof.... -----------------
Hom will Building be ------.....................Will Building be on Solid or Filled Ground?...... ........I-----_----------------
Size of Ceiling Joists--------7�'a I---—- ----------- Distance on Centers........�711... Greatest Span......(e��...j��_---------------------
Size of FloorJoists-------- ---------------------------------- Distance on Centers.. —--------- ------- Greatest Span.......... -----------
Distance on Centers . .. .. . .. ........................ Greatest Span--------------------------------------------
Size of Rafters...----------- -- -- -----
This rectangle is to represent the lot
Locate the building or buildings in the
right position. Give distance in feet from
R 0 all lot-lines and existing buildings.
�Tt�,Qc BEACH REAR LOT LINE
6_�
OF'r
Tw�'copies of plans and specifications shall
be ubmitted with application. 005
Ins ections required.
Z
1. then steel is in place and ready to pour foorting. '6�' Z
2. en steel is in place and ready to pour columns a /or 10—
!�dt�O
3. en steel is in place and ready to pour beam. T-4i
4. When framing is completed.
5. Vhen rough plumbing is completed,and ready to c up.
6. Vhen septic tank drain field or sewer is laid b'?before it is cove,ed. Q
7. �'lectrical inspection by City of Jacksor.ville. rn
8. 'inal inspection.
No e: In case of any rejection,re-inspection MUST be called for after
corrections are made.
FRONT'OF LOT
In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said
rwtw 70 in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building
ti�
ons of the City O"tlantic Beach. 091:
Si nature of Builder__64_�/ ".-J..X Address.4
................ .......-------------
1,;" 14-1..... ..............
/4.w el)
..........-
Slinature of Owner._ Address...7
sA m
tit
—iA—N
DEPARTMENT OF BUILDING
PERMIT No.
CITY OF ATLANTIC BEACH,FLORIDA
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
Date DECERBER 17 19 82
Valuati n$ PLUMBING
—Fee$ 24.00
Thi�permit not valid until above fee has been paid to City Treasurer,and is
subject to revocation for violation of applicable provisions of law.
B & G PLUMBING C01VANY
This is to certify that
1& 13997 BEACH BOULEVARD, JACKSONVILLE, FLORIDA
i
has per�mssion to build INSTALL NEV PLUMBING AS PRR PLANS
Classification SINGLE FAMILY Zone RS-1
Owned:by— BETTY HILL
Lot 7 Block 27 S/D ROYAL PALMS!
409 SAILFISH DRIVE
House No.—
According to approved plans which are part of this permit
NOTICE—ALL CONCPLETE FORMS
AND FOOTINGS MPST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID Sl�� MONTHS
AFTER DATE OF ISSUE
4 01 4 1_10 0 Building material, rub$ish and debris
4 from this work must not be plac4:
in public space, and njust be cleared
up_knd hauled away by either con
.bract owner
11,24*UUCK T
M.
Puilding OM C A* i
FOR OFFICE PERMIT DATE CONTRACTOR j
USE ONLY NUMBER jo
PLUPOOING
ELECTRICAL
SENVER
WArER
I)AI E
1,,"J"I kL
"ti)1)]Tj 01,
FI
please print
j-y OCCUTA'JiONAL LICH-N'SE No.
-F
;AE CE NO.
COl"T',',ACTOR
- - -------------------------------- - -- - -
U?,INALS FLOOR
27 0 Ry BATE Tl:��S
1)i S H'v.' IS P S I)! SPOSALS
FjS S�107-1-'-ERS WATER F.-�-!,'i-ERS
TOTAL )'T U ll' COUNT
-CP OTEER
I 1�c; INE
9P- !�WK
-10, -D TLIST
0 F pi --�BING A2' FI>;Tt:,R-FS
CE I-,jTH TFE ��JOST �,EC-ENT -EDITION
ST D RD PLUMBI-NG CODE. S] GN
f'ORE t7"-17
OT 7)`-!-":D -:--Oi, E-, 1 u RE 'Cl;I T
Is ED A's li�'7
S'
is A B 1� T -',:-D A!
IS i,
C0'l-' "CI'D TO —HE CIT--'� �':A-� S- S (c)
T)r R S ?LR UINIT CON-1ECIED TO Ti4-'--- CITY S'� SEC. 27-3
14 ':1 OP W/O OVER S-0-'s-K R S-TAIL,
I -i----T-uTB ul-l/
-P cc)'�ISISJII�G OF
A C-ROIJ
L-, ER CLU-1-SET, 1-�VATOPY �x B-L'-CH F-,-AD (2 1 TS) D'-.-E S T I C (2 C'
OR S;-2O,,ER S----A—J-L (6 UNITS) BIPCZ- T (3 UNITS) ',;�,:)RY T-!LAY
�OM-BINATJON SIN71" & 'IRAY 7)'HNTAL LAVATORY (2 UNITS)
'y
(3 UNITS) (I LTNIT) KITCHEN SIN ,
co"B11�1CM01". SINK & TRAY W1 D!NTA-L UNIT OR C-CSPl- (2 UN!TS)
FOOD DIS. (4 UNITS) (I L-iNIT) KITCHEN SIN-K 14�
DC R
WASTE GRI"T EP,
DRINKING, FOUN'TATN (!� UNIT) DI SH,:ASHER (2 UNITS)
PLOOF j-,%VATORY,
DRAINIS (I UNIT) 1-!�VATORY (I UN I T)
'z:,:-tjj-j-y PA-PLOR
I!--',VATORY 31 SURG-EF'ol-S (2 UNITS)1�1 SIMWERS Cj�'O-UT P'-ER KAD (2 UNI TS)
�SU,RGFONS SINK (3 U-NITS) UNITS)
POT, SCIA-LT-RY
FLUSHING RIM SINK (8 Ull"ITS) CE SINE TRAP SINK (4 U-NITS)
-�%D (3 UNITS)
URINAL, PEDESTAL, SYPHON JET T UR1,1NAL STALL,
Biff.-'OUT (8 UNITS) UkINAL, 7v�ALL LIP v'-'.SHOuT (4 -L:�.I-
'!-,-�OUGH EACH 2' 0; W'�tsfl SINTY. E�
W-ISHING --!'�C-HINE F�-Es-
SECTION (2 U-NITS) UNITS) OF' FAUCETS
CI.OSETS, ---R C--OS HTS, VA-LVE (2 I-N-ITS)
-I'l S)
c;:: -H T E D (4. U,"-I T S
CITY OF ATLANTIC BI�ACHI FLORIDA
Approv"b PPLICATION FOR ELECTRICAL PERMIT
1 D THE CHIEF ELECTRICAL INSPECTOR: DATE:
11 APORTANT NOTICE:
IN CONSID I ERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE
i
EEREBY AGREE:,TO PERFORM SAID,WORK IN ACCORDANCE ITH THE ATTACHED PLANS AND SPECIFICATIONS,
HMICH ARE A PART HEREOF, AND IN�ACCORDANCE WITH TH ELECTRICAL REGULATIONS# CODES AND CITY OF
LLANTIC BEACH ORDINANCES.
RE
'C
AB
H
N
LECTRICP&FIRM: MAInR faCT A JOURNEYMAN
A M ADDRESS: RFD-BOX
ME
iLDG.SIZE 3ETWEE,�-
ES. APT. I I COMM. PUBLIC I INDUS. NEW( OLD(, ) REW.
ODITION TRAILER I TEMP.( SIGNS SO. FT.
FEE
SERVICE: NEW( INCREASE I I REPAIR
AMPS COPPER f I, ALUM.C
T OR BREAKER 0 AMPS Z PH W VOLT RACEWAY
A
IST.SERV.SIZE, AMPS, PH W VOLT RACEWAY
NO
SIZE SIZE
IGMTING,OUT�ETS CONCEALED, OPEN TOTAL
ECEPTACLES -CONCEALED OPEN TOTAL
0.30 AM 31-100 AMPS.
SWITCHES
:1,INCANDESCENT
FLUORESCENT M.V.
FIXED' 0.100 AMF5 I OVER
BELL TRANSF.
APPLIANCES
kIR M.P.RATING H.P.RATING
-ONDITIONING COMP.MOTOR OTHER MOTORS. APS CEIL HEAT: KW-HEAT
0-1 OVER
WOTORS H.P. VOLTAGE PHS NO. 1 H-P- VOLTAGE PHS
SCELLANEOO'S
TRANSFORMS
T _�S' UNDER 600 V. OVER 600 V.
NO. KVA I NO. lKVA
VA. MA'. MOTOR SIZE SWITCH
i NO.NEON TRANSF 0. FLASMER
EACH SIGN IN
FORWARDED
$
TO�AL FEis
"IT
I)A] E
NFW ]*)*),E OF "I'll I-I)ING
S *.AME
Y,LPI P E Y,�_s I i)yI;"jAAL
ADDI T]01; -CO.-MERCIAL
C Al I 01%'�
FIRM AT DRESS---..----------------
ASIER PLUMBER
please print
1'�Y/(_Olj�TY OCCUPATIONAL LICENSE NO.
TATE CERTIFICATE NO.
C,jLD--;'P R CON'TRACTOR
------- ------------ --------------------------- ---------------------------------------- - -----
S i S LAVAI ORY BATH IUBS URI NZALS FLOOR DRAINS
CI-CfFTS SHOI-11ER-S WATER HE-21,TERS DISH'v:),S)�ERS DISPOSALS
�'_ACHJNE OTHER TOTAL FIXTURE COUNT
11_�S,V,ItLLAI�IION OF PLIC-IBING AND FIXTURES �-WST
E 11,' ACr_0PDA_NCE WITH THE _MOST PECFNT EDITION
S T D.�,.RD PLU�-LBING CODE. Sk;ATURE OF �-'�j%S'IER PLUMBER.
FIXTURE LTIN 1 T Bi�_--'.KDM�
klfS ARE EST.t-BLISHED AS THE OFI�.:A'jER FOR EACH WA.,_TER FIXTCRE UNIT
-i:RFBY FIXED AT
NI U7
.--' D CO.'�' FCIED TO THE CITY WATER SYSJEY,. Ili-E WATER S PPLY C1-1APGE IS Ii
EN �_,r.11_1_i�ARS PER FIXTURE UNIT CON*1\-ECTED TO THE CITY WATER SYS!---Y.. SEC. 27-3 (c)
SHO-ow-ER STALL,
_61 1;.A1-'Ru0M GROUP CONSISTING OF BA ii TUB (W/OR W/O OVER
1�:.-TER CLOSET, LAVATORY & BATH HE- SHOWER) (2 UNITS) DL)"1,-_-:STjC (2 LNI-,
TUB OR SEOWER STA-11, (6 UNITS)
BIPICZT (3 UNITS) LAb�,DRY TRAY
COMMINATION SINK & TRAY DEE t ITAL LAVATORY (2 U-N I TS)
(3 UNITS) (I UNIT) KITCHEN S1NK
CON'BINATION SINK & TRAY W/ DEP'1TAL UNIT OR CUSPI- (2 'UNITS)
FOOD DIS. (4 UNITS) DOI'L (I UNIT) KITCHEN SINK W/
)RINKING FOUNTAIN (15 UNIT) Dl�I;0,�ASHER (2 UNITS) WASTE GRINDER
FLOOR DRAINS (1 UNIT) LAVATORY (I UNIT) LAVATORY, _Bjk-�3E ,
L,�VIITORY, SURGEONS (2 UN I TS) SH(;)1%1ERS GROUP PER F Ek]) BEAUTY PARLOR
SURGEONS SINK (3 UNITS) (3 : UNITS) (2 UNI TS)
.�FLUSHI-NIG P,1M SINK (8 UNITS) SEf�VICE SINK TRAP POT, SCULLERY
1 SINK (4 UNITS)
�I RINNAL, PEDESTAL, SYPHON JET STA�NID (3 UNITS) URINAL STALL,
� LO'-.-'OUT (8 UNITS) URI INIAL, 1..IALL LIP -I I S
WASHOUT (4 Uw.
(,RIN.kL TROUGH EACH 2' (4 ,UNITS)
ECTION (2 UNITS) WA.5HING RES. WASH SINK F-A SE7,
(3 :UNITS) OF FAUCETS
i..A-j-FR CLOSETS, TA�Tk- 1-.1AIER CLOSETS, VALVE (2 LTIN I TS)
�F_FRATED (4 UNITS) OP P-AIED (8 UNITS)
_c, TS
DATE
1.EW
'1')')'E OF
AME YLI'l PE
ADDI T]ON
")CA] I ON�
1-lu-."IBING1 FIRM AI)DRESS-
A.STER P U11-iBER
please print
ITY/COU IN-a OCCUPAI-10NAL LICENSE NO.
TATE CERTIFICATE NO.
L'ILDER OR CONTR.ACTOR
------- ------------------------------------------ ------------------------------------- - -----
SINKS LA.VA]'ORY BATE TUBS URINALS FLOOR DRAINS
CLO ETS SHOVII ERS WATER F��ATERS DISHv.`ASHERS DI SPOSALS
S TOTAL
1NG X-!�CHINE OTHER UR-E COUNT
+XT
.'�-STALLAITION' OF PLIO-�BING AI�D FIXTURES �FUST
F 1', A(!C0P:1-'-N- CE W-17H THE MOST R--ECFNT EDITION
SOU'J-t-,"ERN STA.,,,-D,�RD PLLMBING CODE. SIGNATURE OF M-kSIER PLU-IBER
FIXTURE UNIT
!U-NITS ARE ESTABLISEED AS THE NEASI:i��-ENT OF"..'ATER DH-)"�LN`D FOR EACE WAIER FIXTijRE LINIT
-ECTED TO THE CITY WATER SYSIEM. THE 1%'ATER SUPPLY CW.PGE IS HT-R-FBY Fl)CED AT
E
-;D A-ND CO'�N
D,)! 'NIT CON-1-:1-:CTED TO TTIE CIT 16"ATER SYSTP�. SEC. 27-3 (c)
-11,4,RS PER FIXTURE b y
FAi-1-:JR00M GROUP CONSISTING OF BA]-HTUB (W/OR W/O OV-ER S-30'v'---ER STALL,
-.7ATER CLOSET, L-4VATORY & BATH
HE-AP SHOWER) (2 UNITS) !)L'�-,i:STJC (2 1:."
rUB OR SiiOWER STA-11, (6 UNITS) 131I)GET (3 UNITS) LAUNDRY TRAY
CO\M- 1NATIO1N SINT, & TRAY (2 UNITS)
D.7PT TAL LAVATORY
UNITS)
(I : UNIT) KITCHEN SINT,
ONBINATION SINTK & TRAY W/ (2 UNITS)
CIOD DIS. (4 UNITS) DENTAL UNIT OR CUSPI-
DOA (I UNIT) KITCHEN SINK W/
RINKING FOUNTAIN (11 UNIT) DISHI,�ASHER (2 UNITS) WASTE GRINDER
�1-00R DRAINS (I UNIT)
t I-A)?ATORY (I UNIT) LAVATORY E-
�AVJATORY, SURGEONS (2 UNITS) SHO'iNERS GROUP PER HEAD BEAUTY P�Rl
�URGEONS SINK (3 UNITS) (3 'UNITS) (2 UNITS)
FLUSHING RIM SINK (8 UNITS) SERVICE SINK TRAP POT, SCULLERY
SINK (4 UNITS)
JRIINAL, PEDESTAL, SYPHON JET S T-1:ND (3 UNITS) URINAL STALL,
�LO'--,'OUT (8 UNITS) URIINAL, WALL LIP WASHOUT (4
(4 U-NITS)
INAL TROUGH EACH 2' ! -P
ECTION (2 UNITS) WA�HING M-ACIINE RES. WASH SINK EA SEI
(3 UNITS) OF FAUCETS
17ATF-R CLOSETS, TA�7K- WAIER CLOSETS, VALVE (2 UNITS)
OFERATED (4 UNITS) CiPPRAIED (8 UNITS)
� iTS
jU
CITY OF
&arjS-dq&U-Ja
Office of Building official ,
REQUEST FOR INSPECTION
Permit JJ
Date- kM- Per/mt 1'."
Time PM
Received
ocality
J b Address
Owner's Contractor
Name MECHANICAL
BUILDING CONCRETE ELECTRICAL Air Cond. &
Framing E Footing 1-1 Rough Wiring R0, gh
Re Roofing Slab F Temp Pole To[ Out �i Heating
Insulation Ell Lintel F] Final Se, er Fire Place E
Pre Fab
READY FOR INSPECTiON A.%
Tues. Wed. �Th Ir 7 Friday P.M.
Mon.
A
Inspection�Made
Final inspection F�
inspector- �rtificate of Occupancy
ate
79,86
F St 1ILDING
WARTMENT 0
CITY OF ATLANTIC IIEACK�
Ito ON ------ -------- -- N INFORA
-,p IN ITION ---------
I WIT L
gpi F
t flumbet: T9 il Address::
yp ATLANTIC BEACH FLORIDA 32233
ermi t T - PLUMBING
L9041, DESCRIPTION,`-----------
Wor ALTERATION
Section:
Lott B ock,*
nsltlr Typ WOOD FRAME
ed Use: SINGLE FAMILY Toiwnshi�: RNG;, 0
v, on: ROY
I linjs: 11
Code,.* 0 Subl i ilia i AL PALMS
boated valuet
IMprov.- C stl - $0.100
$25-00
Totall
'60
oun
LINE
APPLICATION FEES
flom
k_"
t
'4
PERMIT $25.00
IMP, CT
ss . I'SH DRIVE W $0 .00
T
H, 4LORI
'A0
AP
6,
Ph
RADON`GAS;�,H-R,.S $0 .00
W, FORMATIJiN ------- RADON� CAB, 5%,
CA 10
Di UNSING AQYZ IJ
P
SZWER TA MOO
FL 32211 HYDRA 0.00
S LLE, LIC SHARE
JA
lype; , 4 d6NNECTION! QO
ce
,W. IMPACT FEE $0 .00�
ES
NO FOOTINGS MUST BE IN 0 WORO POUAING
-ALL CONCRETE�ORIYIS A
14OTIC�
PERMIT VOID SIX MONTHS AF TEA,DA OF ISSUE
I*Ul L ING AL,RUBBISH A SRI$FROM THIS WORK P I UST,NOTBE PLACED IN PUBLIC SPACE,AND MUST BE
M. ATERI NO DE
�H
X'EARED UP AND AULED,AWAY BY EITHER CONTRACTOR,OR OWNER
ts
NIIIAVY
WITH THE VE
FAILURrE TO' COMPLY �PPAK , t4N'A
041cs, JOE
#,`A:,PAYlNQ TWICE. FOR Sljtl�P WE
INGIM, EMENTSM
iSUED ACCORDING TO APPROVE iPLANS WHICH ARE PAR RMIT AND SUBJECT TO REV ATION FOR
D T DF THIS PE oc
' ' ",�tOLAtIONOF,AIIPLICAS.Li�PRiMISt,'O''N$,O'
OF LAW.
0
$0
", I TI -
0000-
KIM,
IMP,
j-
CITY OF AT SUCH
APPLICATION 9upmItICSING PUNIT
JOB LOCATION: SAI L
OWNER OF PROPERTY: /I T 7'1�
BUILDING cow m cToR:._/)I/q Tll�
PLUMBING CONTRACTOR
AND ADDRZSS:
-2
TELEPHONE NUMBER: 7-� V
STATE LICENSE NO: Lw2 -9
TYPE OF BUILDING:
TYPE OF WORK:
HOW MANY OF THE FOLLOWING FIXTURES INSTALLED
_SINKS SHOWERS
LAVATORY WATER HEATERS
—BATH TUBS DISHWASHERS
URINALS —DISPOSALS
CLOSETS WASHING MACHINE
LOOR DRAINS SHOWER PANS
—F
OTHER
TOTAL FIXTURE COUNT:
x $3-50 $15.00 x $
-----------------------------------I-----------------------------
INSTALLATION OF PLUMBING AND FIXTU�ZB MUST BE IN ACCORDANCE WITH
THE MOST RECENT EDITION40F THZ,=RM STANDARD PLUMBING CODE.
CALL A DAY AHEAD TO 8CHZDULZ I IONS (904) 247-5826
DEPARTMENT OF BUILDING P�RMIT NO. 3776
CITY OF ATLANTIC BEACH. FLORIDA
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
Date
Valuation 8100.00 Fee$ 5.00—
This poll t not valid until above fee has been Wd to City Treasurer, and is
subject to revocation for violation Of aPPI'cable Provisions of law.
This is to certify that—John Ii_ill
to remove isting .tin- rch
has permission to build
replace with wood
Classifical, rAsidentiAl—Zone
Owned
S/D
Block—
Lo
House No— 409 ftilf i8h 'Ve
According to approved plans which are part of this permit NOTICIF_—ALL CONCRETE FORMS
AND : FOOTINGS MUST BE IN-
SPECIirED BEFORE POURING.
Pf-,RMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
0 Building material, rubbish and debris
------ Z fromthis work must not be placed in
4 publiI� space, and must be cleared up
and hatiled away by either contractor
or owner.
Oil------------- -------------
Building official.
. ..... 7/14/7a
CO OR
E PERMIT DATE I
FOR OFFIC
USE ONLY NUMBER
7/14/7d
PLUMBING
F
U
0'R
'F 0
FFI
L M 0 ill
U ' N,
E CT IC
M -
LECTRICAL
SEWER
W TE
_YWATER
FOR OFFICE U§� ONLY
__?P/
Date......... .........19 ZA
...Fee
Permit *-----------
CITY OF ATLANTIC BEACH Valuation $------------------------------------------------------
FLORIDAHouse *-----------------------------------------------------------
............................................................................
APPLICATION FOR BUILDING PERMIT ...........................................................................
............................................................................
Aoplication is hereby made for the-approval of the detailed statement of the plans and specifications herewith submitted for the
buRlding or other structure described. This application is made in compliance and conformity with the Building Ordinance of
th� City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic
Boch and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether
he�ein specified or not.
I
The Contractor or Owner-Builder who has been issued a Building ermit is automatically responsible to ascertain that all sub-
ment regard-
cotractors engaged by him are duly licensed in the City of Atlanfic Beach,Florida. To prevent delay or embarras
ing intermediate or final inspections it is suggested that -a list of sub1contractors be submitted to this office so that licenses can
b�I verified. Date......7/e 5/ '?k.................................
0......2.. 7
'-4ner---JPA ------------------------------------------------------------Address_.�V _A?!!A_��AjH.Ahelephone N
Ahit t ----------------Addresa._.,........................................................Telephone No-_-------------------------
'�c i ec .-._-------------------------------------------------------------------------- _Yja pa 17
ntractor Builder---4.0)+�o------4-twrr------------.........--------------Address... ..T ............
it(642141+ -Ar elephone Nol
............................
LtNo..-----------------------------------------------Block No--------------------------------Sub Divis on...................................................---------------------.....Zone......----------
I Street-.--.--.----------------.,Side Between--9'4 ---i�----�'icew-----------------and------------------------------------------------------StR-
ti o n $ A-0. For what purpose will building b&/used_..fA1rA!'\k-..-.---------------Type of construction----_------_------------------_
S'mensions of Building---------------------------- ....Dimensions of Lot----_-------........................................Size of Footings--------------------------------------
ze of Piers-----------_---------------------Size of Sills.----- -----------_-_--Greatest Sill Span in ft------..................-Type Roof------------------------------------
liow will Building be Heated?---------------------------------------------------------------Will Building be on Solid or Filled Ground?--------------------------------------
S�ze of Ceiling Joists---------------------------------------..' Distance on Centers.......................................... Greatest Span_---------_-_-------------------------
S�ze of Floor joists--------------------------------------........Distance on Centers....-... ................................ Greatest Span--------------------------------------------
e on Centers........ ................................ Greatest Span--------------------------------------------
Oze of Rafters----------_-------_-------------------------- Distane af
P AW 444e This rectangle is to represent the lot.
Locate the building or buildings in the
C1 P P right position. Give distance in feet from
Ty A rUNrICZ0 all lot-lines and existing buildings.
SEA CH REAR LOT LINE
o copies of plans and specifications shall JUL
submitted with application. 11 4 1978
Inspections required.
1. When steel is in place and ready to pour footing.
Z
2. When steel is in place and ready to pour columns and/or lintel.
I i When steel is in place and ready to pour beam.
When framing is completed.
When rough plumbing is completed,-and ready to cover up.
When septic tank drain field or sewer is laid but before it is co ered.
Electrical inspection by City of Jacksonville.
Final inspection.
Note: In case of any rejection,re-inspection MUST be called for after
corrections are made.
FRONT OF LOT
In consideration of permit given for doing the work as described in the above statement, 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 building
xegulations of the City of Atlantic Beach.
Signatureof Builder............................................................................... Address........................_.............................__....................... ......
ignatureof Owner.............__--------...........................-----------................ Address....................................................................................................
077
ov � N1
L �X�ql A� ill 31
-it of R,-,Y�jj F�i,�11, 11)"; 1 Im t
PI,
L6t P�,Jock 27 , as ShOw"
p, !,C an(I I D of 01"
I A
For: John
'12
21
15
S-. e7l,
-TZ4) o
LA i
W vi-
cg�
..........
MAP SHOWIN6, SUAVEY OF
Lot 7, Block 27 ,' as shown on the Plat of Royal P'alms Unit 2A C-ts recorded in Plat Book 31,
Paqes 1 , 1A, IB I IC and 1D of the Current Public Records of Duval County, Florida.
For: John Hill - N.H.A.C. Leslie
Your File No. 4215-A
K"
A
Z5
-rc)V-1y,
p CONC. ES L-K.
N2 409
13.-7' 9 1'
9 9.8Z
MC-). 12- -4:3 &7-W.
FOR O�FICZI USE ON
or D
MAO
CITY
ilifie
- ------- Permit
Valuation
Aptilication �bt �ermit
446
Ouse
for Misc. A
and lkej�iiir*-
)ESCRIBE:
�1,or move building er6ctawnings
(state 'if to repair, alter, alao
gh
igh,
Sub'tivi.
ot 2
uilding -77 BA
&
,A -.,e Valuation
'dress.
er s Name
BUI 4dS & OCCUPANCY
Building, osd Residentialbr. susi�68s
What pituoing wor1t I to be done?
Size 'of P*ebent Bldg" of Extension
tot size Material ,O' f Roof,
� 00- of st ries now after alterqd.
J aterial f Present Building �Material of Extension
f
PIA&S MUST E §USMITTED MMT_H
SIGNS
Classification
: :Size
(state whether ground, f, wall, �'�projecting
111110
banner)
Material o! f construction
lluminated? Tvve of i,liuminaticn';
Sta t6 Whether 1
amps or neon)
11 sign,ibe over public property?_
'OF HANGING
SUBMITIDRAWING SHOWING CONSTRUCTION OF, SIGN AND METHOD
WRITE ADDITIONAL INFC RMTION BEMW
(For canvas awninq' O, provide dimensioned drawing on reserve side)
�IMPORTANTrNOTICt:
In consideration, of permit given V doing the wor1c
�in the above, stAtement, we hereby agred to perform said work in
jaccordanc with the attached plans and specifications, w1iich. are a
lj�part bereof, and, in ac cordance with the buildi 7egulati�ns of the
Be Ch.
'City qfA,11lanti OOU Code)
c OL Sa ard
jSignat of- Builder!
4 one
4. Z
Address
4
DigpARTMENT OF Olt ILQI He
FT , CITY OF ATLANtIC i EACH
I6N ------ - LOCATION INFOUATIOW
sit, -'RIVK
Addresg'. 09 SAILF1 _0
er 71650
rva, 32
AIL, 233'
Ad rLANTIC BEACH. F LOA
*OOF
ScRIPTION
--------- L EGAL DE
k'
ot NEW soctil
Lot: k,
Subdivksiom'. ROYAL PALM
4i
jl� Code: 0
T
�$14.00
$0.00
22, 50
"Pa,
v v I'TV Pat $01 gja� IMES
EES
;4;,ATION F
2.
IT ,
FEE
oy AT
jDdj( 32�3
44
L ,d
AT
to,00
AT K
S9. $0.00
AD 0
$0 i 00
ON9 $0
l,ONTliAc ON GAS
T li,10AbVit,
4*190
TA
3LIC9- 0m, 0 .010
YDAI ARZ
0 .
ype: 09 RO S CONN ON
zc�
8C—.dOTRZR 0.
1 T
D BEFOR4 POURING
T 6,15 Ims
NOTIC ALLCONCRETE:FORMS AND FOOTINGS IW US
E OF IS UE:
PERMIT VOID SIX,MONTHS AF TER OAT 1 $
IATE�IAL,RU ISFROM THIS WORK OUST NOTSEPLACED IN Puatic SPACE,AND MUST BE
uiLome
"A IV BBISHANO'DEBR
NEA .
HAULED AWAY By EITHER CONTRACTOR OR )W
J EAA
40�UP AND
All�
WITH THE
-RETOCO Y MECHANICS' LIEN LAWJCAN RESULT IN
V L�,
PR
YIN'G TW OR L . EMENTS.
OOEAT'�'OWOEA.PA ICE FORtUlLOING IM OV
SUBJECT TO REVOCATION,
ED;ACCORDING TO AP"OVED PLANS WHICH ARE PART OF THIS PERMIT AND,
SU
EfROVI$lONS OF LAW.
(OLATIO OF-APPLICASL
ML
6UILDiNd DEPARTMENT
A
CITY OF ATLANTIC BEACH
PERMIT APPL1CATIOD ROOFING
Owner( s) : -vo-
Address: Phone:
Lot # Block or Unit Subqivision--
Contractor:
Address: ma
Phone&,
L Z9
V
State License No..
Describe work to be done:
rL g
Materials to be used:--(�h
7
Signature OWNER: Date: 9�3
Signature CONTRACTOR:
1000'