387-389 4th St (vault) (2) CITY OF ALANTIC BEACH
ROOFING PERMIT APPLICATION
owner(s ) : Zle�-v-lkl 6
Address :.-...,..,,,3V —Phone :
Lot # Block or-Utr±-t–#__ 6 Subdivision:_S;!�7C7--
Contractor: 0-167
Address :
City, State and 136�_6(cfy —Phone
State License #
Describe work t be dnoe : 1e7_e+'X- OX,4 _3� A/I-V C1 6
Valuation of Proposed Construction: '�/?
Materials to be used: ff6E?0 vt--Z i e G:4 1&-5.
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Signature of owner; lz_t'�
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Signature of Contractor:
F7' 6_57
Liability Insurance Supplied
Workers Compensation Insurance Supplied
License Information
MAP SH6 ,17NG BOUNDARY &_RVEY OF -/Or 3 Z
LOT 34 _ BLOCK __ ---- AS SI-10 WN ON MAP OF
,4rZ,4A11 le 9_z�ell s,11S,01V150,0 5,ffr/ox/ A
AS RECORDED IN PL AT BOOK S PAGf.S 9 OF THE PURUC RECORDS Or DU
VAL COUNTY flORIDA
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APPROVED 3
CITY OF ATLANTIC BEACH
ovd'_ BUILDING OFFICE obb000 o
75.00' MAR 3 1992 c = = 'a ::
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NOT VAUD UNLESS EMBOSSED W7H SEAL OF THE UNDERSIGNED.
I HEREBY CERT7F-Y THAT THE_Z07__SH014,N HERFON IS IN THE SPFCIAL FLOOD HAZARD AS SHOW
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0002530
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DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
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T-oRJIIIT INFORMATION ------- LOCATION INFORMATION --- ------
4t, umber i 2530 AdOreani 387 389 FOURTH STREET
.ral, Types OTHER ATLANTIC BEACH, FLORIDA 32233
a o 'A
Work -AC1)DrTXON ------;-- -- LEG L DESCRIPTION ----------
'etr Typoi CHAIRLINK Lot% Blockv Sections
Po d Uvoi SINGLE FMLY(ATT) Townships RNG: 0
lin 03 0 Codes 0 Subdivisions atlantic beach
**at d Valt(r'll, 00.GO
vpr V. Co*t I
TO *I pe"� l *10-00
Aoo nt Pe' d ........,,,
.100
0 to Paid,: RLI
c* 1 a di along side property line end rear line
- ---------
APPU ICATION FEES -----
Ow
xzv g 1 *10. 00
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--FEE
ET W� TER IMPACT $0. 00
SOWER IMPACT:-�*� ZE All
ATLAOTJ L_#r DA 32233
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4?-`��f` 'gw
(90
5
R Doti 4O.d6
R DO" GAS 5% *0.00
w 1`0
CONTRACTO
W TER TAP $0. 00
Soo t,
'else
S WIER TAP $0,00
HIDRAULIC SHA'R9 *0100
Ype% 0 RI -INSPECT FEE *0. 00
EIGINEZRI"O' w
*0.00
01HER $0.
o 4%
..........
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NOTES:,
NOTICE —ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE Or ISSUE
BUILDtNG MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUSTRE,
CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER.
-N LAW CAN -RESULT IN
TAILURE TO COMPL
Y WITH THE MECHANICS' WE
&,4,!,OPERTY OWNER PAYING TWICE FOR, BUILDING IMPROVEMENTS.
OM, W54
IRDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBMIT TO REVOCA71RO OR,
PPLICABLE PROVISIONS Of LAW. $1 0
W. CEIPT M)WRI WM
DtNQ�QEPARTMENT
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APPLICATION FOR FENCE PERMIT
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Owners nameA�,
ICA
Job address- - -------------------------
,or 1-..r 3-V
Lot 32.-W, 25' -block and/or unit, #-------------subdivision
Contractor if different from owner
-----------------------------------------
Valuation of fence Corner or interior lot
Type construction_.,P. 11v 'o 6
Show location and height of fence as well On location of street(s).
A 77—A erov EJ--.)
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"Poop"Aroe-rY' A,''Ove, 0-ow *^o ?Pe veo a -r V
441YE-. -7- * " It- ` #'S t- 00,, r I Al C"t 6 HS 04
6 AJ 7'V 40VI Al 4 7-Y
Owner signature 7 X
------------------------ Date ;��
---------- - ---------------
Contractor signature-----------------I-----------------Date
CEN 77FIE0 FOR.. ee-VIAI ol 40A rwlelA SA041��4'AlAle-r-f &ggg6er
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je ag1oWry go.
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,v0T VAUD UNLESS DIBOSSED W7H -4E4L OF THr UqDjRWGNED.
I NEWSY CER77FY THAT SHOW HtqMN IS IN THE SPECIAL F-LOOD HAZ4RD ZONE x AS SWW
ON FLOOD INSURANCE AA7Lr 04AP 000" FOR A7eq1-17;,e FLORIDA, DA7ED 4---'749�
TRT-STA fy7L-1
LAND S UR VE YORS, INC.
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8411 BA YMEADO WS WA Y SUI 7E #2, JA CKSON ALE, F7-ORIDA 32256 (904)- 731-7235
LEGIEND I HEREBY QM77FY 7HAT 7HE ABovr LANDS IWR_r SURWYED UNDER MY
I CONC mrw RE'SPONSIBILE SUPER W90N AND DIRE-C 770N, 7HA r 7HcRr ARE No
E)VCROACHMENTS EXCEPT AS SHOW AND THAT THE SURWY -Wow
HEREON MEM 7HE MINIMUM 7E*CHNIC4L STANDARDS
IROV CCI�' �PA- -- . - -- SE7 FOR 7H BY
ATLANTIC BEAM
CITY Of
-Q VIOlArION 1URM
ODE
Date 5
..''-'Address and/or Location of Violation -C/
Owner and/or Tenant of Proper
SIG4A= OF 001I)IMNARl' Phone
ADDRESS
----------------------------------------------------------------------------------
Date of Investigation investigator
Conditions Found
Action Taken
Ccupliance
NC(IE,S:
AM
APPLICATION FOR FENCE PERMIT
Owners ...phone
-------------
Job address--2t7 !>7
Lot--3 V ----block and/or unit #-,15L1qC-& -subdivision---<�C fLl'ge?�.A......
Contractor if different from owner-- VvAle-R- 0 Ai;-IQ-eq-C -rop,,,
A- -------------
-----------------------------------------
Valuation of fence $--12 -170 ..... Corner or interior lot- ..r AJ 7, E-K (04-
,/?( (f 54-A rS
Type construction_-/ ./—,
Show location and height of fence as well as location of street(s).
-s Z4,Q
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Aj ct '4W 'I eAe
7
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j* PT-,-.LANT1C, BEACA
O, FFICE
Owner signature_
- ------ ---- ------- --------------
Contractor signature----------------------------------Date-----------------