620 6th St (vault) CITY OF ATLANTIC BEACH
APPLICATION FOR ROOFING PERMIT
BUILDING OWNER LL PHONE
JOB ADDRESS Q 6 57-
LOT1i� BLOCK OR UNIT H SUBDIVISION
CONTRACTOR �,C J Sr�CFX„ l�o6fi PRONE-,;?,
ADDRESS�,31
LICENSE NUMBER
EXPIRATION
JOB VALUATION $
MATERIALS:
SIGNATURE OWNER
DATE vv
SIGNATURE CONTRACTO UA'I'Ca9
7,50 TL
DEPARTMENT OF BUILDINGc /ft
1 CITY OF ATLANTIC BEACH,FLORIDA PE"%NO•
PERMIT TO BUILDP.`' ° � ^�
THIS PERMIT MUST BE POSTED ON JOB i�f3fi
Date 9/29 19 86
I Valuation$ Fee$
7. 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 NEW JERUSALEM ROOFING
RC-034687
has permission to bui RE ROOF
Classification RESIDENTIAL Zone
� Owned by
HARRELL
Lot Block S/D
� House No.
620 SIXTH STREET
j According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
j PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
----00 4 0 Building material, rubbish and debris
I from this work must not be placed
in public s ce, and must be cleared
up and a ed away either con-
tract owmgr.
Ile
i
) it ng official.
FOR OFFICE PERMIT DATE CONTRACTOR C.._
USE ONLY NUMBER
PLUMBING
ELECTRICAL
SEWER
WATER
,ems►„