705 Atlantic Blvd (book store) 2012 repairs CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001627 Date 11/07/12
Property Address . . . . . . 705 ATLANTIC BLVD
Application type description COMMERCIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 18000
----------------------------------------------------------------------------
Application desc
general interior repair
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
DORSCH SALTAIR PROPERTIES LLC ANTHONY GENERAL CONTRACTORS
2517 HOLLY POINT RD E 596 ABERDEEN CT
ORANGE PARK FL 320735632 ORANGE PARK FL 32073
(904) 655-9922
--- Structure Information 000 000 INTERIOR REMODEL ADA BATH
Occupancy Type . . . . . . BUSINESS
----------------------------------------------------------------------------
Permit . . . . . . W/W/O BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 280 . 00 Plan Check Fee 140 . 00
Issue Date . . . . Valuation . . . . 18000
Expiration Date . . 5/06/13
----------------------------------------------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, FLORIDA FIRE PREVENTION CODE
2008 NATIONAL ELECTRIC CODE
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 4 . 20
STATE DBPR SURCHARGE 4 . 20
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 280 . 00 280 . 00 . 00 . 00
Plan Check Total 140 . 00 140 . 00 . 00 . 00
Other Fee Total 8 . 40 8 . 40 . 00 . 00
Grand Total 428 . 40 428 . 40 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 DID
e 5- f2 7 Pc24?0247-5826 Fax(904)247-5845
Job Address: `, 4T-A kJ4C Ad) Permit Number: r) ` 16d 7
Legal Description t
_-o-�s n�4�- rlso Sec. ( , S�l�a.' w, . Parcel# fi 8 (O pc, jut VGG�
mor Area of q. t. q. t
aluation of Work$ 6n Proposed Work heated/cooled none heated/cooled
/Class of Work(circle one): New Addition Alteration Repair Move Demoliti0 ifId Yw/ziv ,p
Use of existing/proposed structures)(circle one): 5eiirc
Peone):
Residentialt
If an existing structure,is a fire sprinkler system insta Yes (f o� A f
�lorida Product Approval# �—f COPY '
$
For multiple products use product approve orm ,
./bescribe in detail the
the type of work to be performed: �'/ �c / lve)
Property Owner Information: N
Nae:�Qg ��+6 Q Address: S _ ��U b 1 44 ►` E
City S to aZip ,-?2Q Phone
E-Mail or Fax#( ptional)
Contractor Information: +
Company Name: A� u �1J Ar,"V- Qualifying Agent: /nA4ek Pr' J;Z�N6ft
Address:S e Of- City 4,P State- FI—Zip,3—
Office PhoneQ04a,7a=q -Job Site/Contact Number S Fax#
State Certification/Registration#
Architect Name&Phone# -REVIEWED FOR CODE COMPLIANCE
Engineer's Name &Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address Iq
RilitlNT.D 131x': DA1T:
Application is hereby made to obtain a permit to do the work and installations as n e r r to the
issuance of a permit and that all work will be performed to meet the standards of a YtSIYrrZXies nrd(
and void if work is not commenced withirT six(6)months, or if construction or work is suspended or abandoned for a_period of six(6)months at arry time after
work is commenced. !understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Heaters,
Tanks and Air Conditioners,etc
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTENT) TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether sped red herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
/(-,
Signature of Owne Signature of ContractorAp�� _V 1 � �.
Print Name ..._�....�...L_Y....................ry?...�`....�....0 IJ................. Print Name m.o4ek..a.......CrQ N�...�......�<�_1� ..................
Sworn to and subscribed before e Swol o and subse 'bed befo e me
this Day of Si 20 [a this �� Day of 201�-
AR �-IJBLIC p
Notary Pub Ic Not u.16 ',, re hrdM�
MIry wM-lw M f w ►► Com 'ssion#EE05336S
%ftfte8L Expires: JAN.o! Meed 01.26.10
0 of 2"M BONDED nMU ATLANTIC BONDING CO.,INC.
12 -1627
NOTICE OF COMMENCEMENT
State of F/01,Id'a Tax Folio No.
County of to)A
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: ke {57 q - 9 5-0 !Siect 54-1-t-r4lt K��'
i s u m�,
Address of property being improved: C/ V- �. r
General description of improvements:
R��, � 0,-,;
Owner: j lt� S 1E ;�,V5� Address: �?2 IJDllu �=
Owner's interest in site of the improvement: (V `t`'
Fee Simple Titleholder(if other than owner):X25 &711,w(O
Name:
1Contractor: Af J T-S
Address: . 6t1P5G�9lf 2e
Telephone No.: j�`S-�'I� _ Fax No:
Sure (if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person ma ' aloan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State o. Florida, other than himself, designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name: I—cxc i S-E- �
Address: ��t' -a'-sec pe' s o_ G ""��! ;;, a-x R 3�-c3��'7
Telephone No: 3d —Q s? Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: Date:
Before me thisday of� m,U O/ the County of ,e
P r ,State
Doc#2012208136,OR BK 16081 Page 873, Of Florida,has pers�ppeared
Number Pages:1 Notary Public at Large,State of Florida,County of ioval. C/Rt
Recorded 09/25/2012 at 10:18 AM, My commission expires:
JIM FULLER CLERK CIRCUIT COURT DUVAL Personally Known: yeS or
COUNTY Produced Identification:
RECORDING$10.00 Mit Cann
Au�;;2.2018
I'mm is810n#EE 214258
Sond�d 1*40 N�tbnN Ann.
ANTHONY GENERAL CONTRACTORS, INC.
I I 4609-1 US Hwy 17 , S. , Orange Park, FL 32003
(904)272-9598 * Fax(904)213-1161
License#: CGC 059263 Tony Knott, Pres.
(904)655-9922
Custom Homes Jo Knott, Design Coord.
Commercial Buildings (904)707 4957
FAX TRANSMISSION
Date: /!' ���a
TO: m JyNest, �
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ANTHONY GENERAL CONTRACTORS, INC.
4609-1. US Hwy 17 , S. , Orange Park, FL 32003
(904) 272-9598 * Fax (904) 213-1161
License#: CGC 059263 Tony Knott, Pres.
Custom Homes 1 (904) 655-9922
Commercial Buildings Jo Knott, Design Coord.
(904)707 4957
FAX
Date:
FAX #: '�I r `tS
To: r-p e-- ..)D A)e- S
From: To 0Lj Ce 1/
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RE:
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City of Atlantic Beach �,�0 APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road /Z _ z
Atlantic Beach, Florida 32233-5445
Phone(904) 247-5826 Fax(904)247-5845 /1 7
E-mail: building-dept@coab.us Date routed:
16— City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �_, �7 D ment review required Yes/'-No
uilding
Applicant: IRTanning &Zoning
Tree Administrator
Projec : f Z Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
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
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. []Denied.
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING Reviewed by: Date: 7 iZ
TREE ADMIN.
Second Review: ❑Approved as revised. Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
CITY OF ATLANTIC BEACH
i+ 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
DIM
Application Number . . . . . 12-00001627 Date 11/09/12
Property Address . . . . . . 705 ATLANTIC BLVD
Application type description COMMERCIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 18000
-----------------------------------------
Application desc
general interior repair
------------------------------------------
Owner Contractor
------------------------
------------------------
DORSCH SALTAIR PROPERTIES LLC ANTHONY GENERAL CONTRACTORS
2517 HOLLY POINT RD E 596 ABERDEEN CT
ORANGE PARK FL 320735632 ORANGE PARK FL 32073
(904) 655-9922
--- Structure Information 000 000 INTERIOR REMODEL ADA BATH
Occupancy Type . . . . . . BUSINESS
---------------------------------------
Permit . . . . . . W/W/O ELECTRICAL PERMIT
Additional desc . .
Sub Contractor . . KEN KOEHLER ELECTRIC INC 00
Permit Fee . . . . 153 . 20 Plan Check Fee
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/08/13
-------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, FLORIDA FIRE PREVENTION CODE
2008 NATIONAL ELECTRIC CODE
---------------------
-------------------------------
Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 30
STATE ELEC DBPR SURCHARGE 2 . 30
Fee summary Charged Paid Credited Due
----------
----------------- ----------
---------- ---
Permit Fee Total 153 . 20 153 . 20 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
00 . 00
Other Fee Total 4 . 60 4 . 60 . 00 . 00
Grand Total 157 . 80 157 . 80
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 ax(904) 247-5845
JOE ADDRESS: 7?O 5" TLi�/1T�c'
� y PERMIT# /6 72
JEA INFORMATION REQUIRED ON ALL PERMITS CDU AMPS -)`le VOLTS l PHASE
VALUE OF WORK$ /)oa 6_
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
El Commercial(Main)Service
[10-100 amps El101-150amps El151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE El—amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors KVA ❑Motors hp
Qty ❑Transformers
FIRE ALARM SYSTEM (Requires 3 sets of plans) "L UE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change _OH to UG
e0ther: �'LrG�/.PCf C/�ll�l7r5 X02 4Q!¢T5 /TCff D'l�TGN>"s
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Property Owners Name �U�fln L • `�'�sch Phone Number
Electrical Company n C'/f C`C's " _/✓r Offi`c�'e�Phone $0 '- ; FO Fax
Co.Address:
f�X ��s/%�� City .D/lKS4ndl�4° State Z�l Zip
License �`" LC�•e State Ce tiification/Registration
-,'i!^LEY}.GRAHAM Ze
Notarized Signature of 1dcevw4CSA of r
February 14,2014 ►/ 20'L_
Bunded Thru Notary Public Underwrhe orn and subscribed be re is day V
Signature of Notary Pub
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
r� ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
12-00001627 Date 11/08/12
Application Number � � 705 ATLANTIC BLVD
Property Address . . . . .
Application type description COMMERCIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 18000
--------------
----------- --------------------------------------------------
Application desc
general interior repair
-------------------------------
Owner Contractor
_ _ ------------------------
DORSCH SALTAIR PROPERTIES LLC ANTHONY GENERAL CONTRACTORS
2517 HOLLY POINT RD E 596 ABERDEEN CT
ORANGE PARK
FL 320735632 ORANGE PARK FL 32073
(904) 655-9922
Structure Information 000 000 INTERIOR REMODEL ADA BATH
Occupancy Type
BUSINESS
--------------
-- ----------------------------------------------------------
Permit PLUMBING PERMIT
Additional desc 2 FIXTURES NEW
Sub Contractor HERZER PLUMBING SERVICE 00
Permit Fee 69 . 00 Plan Check Fee
Valuation . . • • 0
Issue Date . .
Expiration Date . . 5/07/13
----------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, FLORIDA FIRE PREVENTION CODE
2008 NATIONAL ELECTRIC CODE
2 . 00
Other Fees
STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE
________ -------
Fee summary Charged
Paid Credited
------------ ----------
-------
69 . 00 69 . 00 . 00
. 00
Permit Fee Total 00 00
4 . 00 4 . 00 . 00 . 00
Plan Check Total • 00 . 00
Other Fee Total 73 . 00 . 00 . 00
Grand Total 73 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH -
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904)247-5845
' PERMIT#
JOB ADDRESS: C7� �Q I'l+l CJ ( ) �/
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE of FIXTURE QTY TYPE of FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE of FIXTURE QTY TYPE of FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well
** SJR WD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read
this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to violate the rovisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name ol 1'C'U Y1�Y e Phone Number
�n SVC ,-�' Office Phone x(94"�« Fax a-7a'3`{1la
Plumbing Company C'J� � S Q��f"R� G
� �, City 1-State- Zip
Co. Address: Q 7 - �
License Holder(Print): (_ t P.nQ 1�J UmQLn State Certification/Registration#LFC�-23�"�
Notarized Signature of License Holder_ 1� > n 0!0=4,
q1K da
,Sworn and subscribed before me this 20 � Z
,';y r MELANIE GREEN
ti'. �;: MY COMMISSION M EE 212195 ignature of Notary Public
" EXPSES-July 14,2016
Bonded Thru NOt"PUbRc Urrderw�'he� .
I P`'
1 �v,
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001627 Date 11/15/12
Property Address . . . . . . 705 ATLANTIC BLVD
Application type description COMMERCIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 18000
----------------------------------------------------------------------------
Application desc
general interior repair
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
DORSCH SALTAIR PROPERTIES LLC ANTHONY GENERAL CONTRACTORS
2517 HOLLY POINT RD E 596 ABERDEEN CT
ORANGE PARK FL 320735632 ORANGE PARK FL 32073
(904) 655-9922
--- Structure Information 000 000 INTERIOR REMODEL ADA BATH
Occupancy Type . . . . . . BUSINESS
----------------------------------------------------------------------------
Permit . . . . . . MECHANICAL HVAC PERMIT
Additional desc . .
Sub Contractor . . AIR MAX HEATING & COOLING INC
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/14/13
----------------------------------------------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, FLORIDA FIRE PREVENTION CODE
2008 NATIONAL ELECTRIC CODE
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE MECH DCA SURCHARGE 2 . 00
STATE MECH DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 79 . 00 79 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)24-77--5845 /
.TOB ADDRESS: CUA v' PERNIIT#/�
PROJECT VALUE $
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM --/`� REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
ARI#
Air Conditioning: Unit Quantity Tons Per Unit REQUIRED
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets of plans)
Underground Fire Main Value (Requires 3 sets of plans)
Fire Hose Cabinets Quantity (Requires 3 sets of plans)
Commercial Hoods Quantity (Requires 3 sets of plans)
Fire Suppression Systems Quantity (Requires 3 sets of plans)
FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets Boilers BTU's
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
OTHER:
67-35
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read
this application and know the same to be true and correct All provisions of laws and ordinances governing this work will be complied with whether specified
or not The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name Phone Number
i Mechanical Company ,jx' — �ic�. � �r—''C�_- Office Phoned-�fo ax` s
Co. Address: IALAC , City State-!El-zip32.�b
License Holder(Print): a e Certification/Registration# CAC-O �
Notarized Signature of License Holder
WAY VAU Sworn and subscribed before m/e s /S ' day of / O £m bei2 2049
W
COMMISSION M DD 955354
!=*' EXPIRES:Match 8201
E:';• '�` NNotaryPubkD� Signature of Notary Public
OF
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