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336 10th St 2013 deck/pergola CITY OF ATLANTIC BEACH r s 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 A Application Number . . . . . 13-00003806 Date 12/19/13 Property Address . . . . . . 336 10TH ST Application type description DECK/PATIO Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 8000 ---------------------------------------------------------------------------- Application desc WOOD DECK AND PERGOLA ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- BULL KATHLEEN & NIELS WHYRICK BUILDERS INC 336 10TH ST 4242 LEXINGTON AVE ATLANTIC BEACH FL 322335530 JACKSONVILLE FL 32210 (904) 226-3434 ---------------------------------------------------------------------- Permit . . . . . . ACCESSORY STRUCTURE NEW RES Additional desc . . Permit Fee . . 90 . 00 Plan Check Fee 45 . 00 Issue Date . . . . Valuation . . . . 8000 Expiration Date . . 6/17/14 -------------------------------------------------------------------- Special Notes and Comments Full right-of-way restoration, including sod, is required. Roll off container company must be on City approved list and container cannot be placed on City Right-of-Way. (Approved: Advanced Disposal, Realco, Shappelle ' s and Waste Management . ) 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE -------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 -------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 90 . 00 90 . 00 . 00 . 00 Plan Check Total 45 . 00 45 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 139 . 00 139 . 00 . 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 Office (904) 247-5826 Fax (904)247-5845 i!] Job Address: 3� �1y�1,�/�' n� ,, •�, Permit Number: ( � 3 Legal Description l-ZJt 1VCk �� IrCT[[J��� (fc 1 # ! �� n�o w oorr�reea of ��q. t. 'q.kt Valuation of Work $ Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition p6oVspawindow/door Use of existing/proposed structure(s)(circle one):. Commercial ininti E 0 P If an existing structure,is a fire sprinkler system stalled?(Circle one): es No N /A Florida Product Approval# For multiple products use product apprioval form Describe in detail the type of work to be performed: Property Owner Information: Name: / r i ��'� Address: V44 fit—, City State Q Zip one E-Mail or Fax#(Optional) __— Contractor Information: t 1),� Company Name: f� p���, Quali in ent: io �' ` L) ' V`�''` I` Address: Ci !1 State Zip Office Phone - ob�Sii e/Contact Numbe State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone#_ Fee Simple Title Holder Name and Address Bonding Company Name and Address_ Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. l certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six 16j months at any time after work is commenced. i understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, urnaces,Boners,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 INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. i hereb certify that 1 have read and"ermined this plication and blow the same to be true and correct. All provisions of laws and ordinances governing this type certify will be complied with whether specified 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, pr oca!lmv regale ' g construction or the performance of construction. 1 Signature of Owner ' Signature of Contractor �- Print Name /I/lC�S 57L. ............................_........._ Print Name _......................._.. Sworn to and subscribed before me Sworn to and subscribed before me 2this this Dayof � .20134uy Public Notary Public ►'" Notary Public State of Florida Revised 01.26.10 PkY P sera Lynne Johnson ,�� .•..a�%, ALEXSURRATT a any Commission EE 827455 MY COMMISSION t EE 148216 a nQ Expires 09/24/2018 * EXPIRES:November 22,2015 P 4rE OFF eO Bonded Thm Budget Notary Services nS`TI°'^ '"' T, WH S Tfii'EET l , ' /Vly) -fir L4 lrlm ^io4 GN— kwo �t�t ✓U.UU' �fe� cvcr ar 3F�.r—CU l '�' �r"J U aY'�Yi.I�r4? • �• J 7W,00' (11), 710.03' (t,l) w - r' 3.B• CCNVL 1 1 " 50.06' (R). W.09' (M) �.�...� -.. �.. q )Al- t0 (R) t f0 (F+) 1 10 Ft 4O' ;�) j ) 17ktt:K . .. Ja p / • r A tV.l , M.-•,�•a• /jglW slurs ., - •t x I W/ COL umm , FILE �' 1cotrn .�coTlc Y � ( f' to `OVtFINANGS ! � N y 2 S10RY FRAME � eLfcK SN+Ca Ill L_ 1 RE5"NCL SSS WA11 3 N Ci c) �t�+ N V i W/ TV FAVL5 r w r, [.i U I r. wowuECx as• O _ o `' r� k STEPS i}Y Q A/'- G7 O Q W .-PAU .J ILI H ``+ LJ .I vI" � c: 3 L j4.9' oS.'?tt3F f`eJy 0.3' - CK • I � ��YY.S 7rrlr�jp,1 1P ,....1 ORILK COLLW14 '7/mItl`t 5' _'F w/ . ' rQ'}/t''k1�?rte U+ 1.5'x l.r 4.9' wOCUAI1L" NI _ 40' (li) 0.1 ASSOC.5L1R. !49 90 )f LOT �T} L6.5488 . . �/1'� 1 .uT BLOCK 12 L01 S CJCK 12 i Ji 16. (3L,iGK _ ULOLK x-REI=ERENCC JOB NO_ 37B1_ -*-%v 42 MU.-vic" K! ArMAL t?IAUL'.0 WI}i AVCAAIX AS UL vFFA ER){QI E MOOT li MSOF lift 0. AWA4'E AK�U3S HiANA1t5UUAlK tJ4.E. AM MEAAS DMWILC ED oyOX&M FRAM xa04MALFO lAm19 FLOW j'MNUK oEMnAL NU E3, Y p R S 1. ANGLES ARE SiTOWN FOR IMS SURVLY. +5 L 1}11UCIURE NO. 3x' SIIOVM IEKOI1 UES YdA#N '-Loa) '014 _ x h i,fr,.i., BEST OCIERMMIEO FROM F.LMIL FLOW MAPS PANE_ NU + UAILUa4-t�-t+ A SSOCIATED SURVEYORS INC. 3.DOS S �u�CE UR E OTHE EXTENT Ul `nmHomiu) FoonnPIPE� ASURVEY YNOT OCINE Ll - / LAND & ENGINEERING SURVEYS 4 JURISDIC11014A: AND OR CNVIRONULNFALLY :XNSIDW ANCA', IF ANY. h f/ 384G BLANDING ©OULL�lAitU LOCAiLD UY 11AS SIM y JACKIONWLLE, FLORIDA 32210 5.11415 SURVEY BASED ON LEGAL DESCRA'TiONS ruRmsfiEU IIIc PUC 904-771-6468 RECORDS 1NERE NOT SEARCHED BY 11415 SURVEYOR FOR EA .NTS, H COVENANTS. B.R.L'S RESTRICOONS, CLOSURES. TAKINGS OR URDiNANCES. I p CERTIFICATE OF AUTHORIZAIION N0, LD 0005488 THERE COULD BE OTHER MATTERS OF RECORD THAT AFFECT 11415 PARC V 6.UNLESS OTIIERVOSE STATED ALL F(M PIPES FOUND HAVE NO lOENIFTCAT I HEREBY CERTIFY THIS SURVEY WAS DONE UNDER MY Lj!G WlAD =VIATlQN& DIRECT SUPERVISION AND MEETS IHC MINIMUM TECHNICAL O SET 0W PIPE OR REBAR N.C. - Pmr OF cuovC CH - CHOK -ASSMSTANDAR S EOR UWD URVEYIMG PUW IJANT TO CHAPTER • FOUND IRON ro+o1­13.54813 BarP�(I�) uu"'"" �ONT OF FANGE"CT (Wi AlEASUF - 6101 1 G 17-f� FLORIDA ADM 1 WE CO t, CHAP ER 472. `.�. • FOLAl6 CONCRCTE MOMAIENT(C.M.) �. C 11 W tE {C) - i WPt1TED X. CROSS CUT OR DRILL NOL AA\CCOt+c.-�C(Ml H. .RAOWg O.R.B.OFFICIAL RECORD BOOK L ARC LENT i. � -WATER METER - � O.R.Y.-OFFICIAL RECORD VOLUME C BATCH 1'LORIOA C IFICATE N0. 377 t P.R.M.-PEta><MMI TEFF 41iCE Mof&"Uf P.EQ. •Pom EQL*wNT R.l 1T a C IES L. STARLING rLORIDA RT)FTCATE hIO. 4579 e.RL-EIUILCIiNG TtE4TRICTiON UNE x—x CHAN° cw8 FEJKE / W—M MIRE FENCE 0,T.- HU4DYr0 ,,.,,,,,,,,. .•na,.crc ct rjDtr%h r•t:rYTIP• T97 AIn R t R7 c t .ELECTRIC TRANSFOrtMER r PAD r+- ' ♦YM114aR i. v .: :.i:.Y'i,«yy�'i1oS'y'. .". F I L E C U`P Y NOTICE OF COMMENCEMENT (PREPARE IN OUPUCATE) Permit No. j 3--3(yd6 Test:FWfo No. State of PZ County of_ r.#Va/ 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 followhsg Information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: w " I 4 Address ofproperty being improved:_-33(e 1044 ,1 General description of improvements: i Owner E SAl.r Address e4 S Ownea's interest in stle of the improvement Fee Simple Titiehotder('d other than owner, Name Address tdo Id-AA6 a ti- dress 0 .c. Phone No. X13- t7 Sa Fax No. O 7.3 Surety Of any) Address Amount of bond S Phone No. Fax No. Name and address of any person making a loan for the construction of the Improvements. 1 Name Address i Phone No. Fax No. Name of person within the State of Ffodds,other than himself,designated by owner upon whom notices or other documents may be served: I Name Address Phone No. Fax No. { i in additfan to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in i Section 713.08(2)(b),Florida Statutes.(Fill In at Overees option). Name i Address Phone No. Fax No. i Expiragon date of Notice of Commencement(ttte expiretfon date Is one(1)year from the date of recording unless a different date Is specified): THIS SPACE FOR RECORDER'S USE ONLY DATE Bator.rns tat. dey d in the Cwfrrdio..d.34ted�srW as appeared /.s /). -rein tyy hhnse�h vaef and et=that a9 staremwft and declendlons heroin are into and accursts Doc#2013239182,OR SK 16529 Page 1547, Number Pages:1 Recorded 09117i2013 at 10:27 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAtFWj*-Pt"Cat tavapostalso t COUNTY restate ofFlorida RECORDING$1000 F nMyKnowr era hnson (1( Produced rdenr>rtatlonQ.� EE 827455 i 041 Expiras 09124/2016 IiCity of Atlantic Beach APPLICATION NUMBER Js N Building Department (To be assigned by the Building Department.) 800 Seminole Road 2 �r Atlantic Beach, Florida 32233-5445 LJ n Phone(904)247-5826 • Fax(904)247-5845 i .4 E-mail: building-dept@coab.us L Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: � t h D ment review required Ye No Buil in Applicant: WL-�M In\CJL' I J Planning &Zoning Tree minis rator Project: �L P G �Works Public Utilities Public Sa ety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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: dApproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: 111-11-13 TREE ADMIN. Second Review: ❑Approved as revised. enied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) •` 800 Seminole Road Atlantic Beach, Florida 32233-5445 �+ Phone(904)247-5826 • Fax(904)247-5845 I Z '„yoj �• E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1p 0-1 S� DgDartment review required Yes No Applicant: 1' ` 1) C dning &Zonin ' ,� 1 re minis rator V Project: C0J L02YAO CK, Work 4Public i i i Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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: �Pproved. ❑Denied. (Circle one.) Comments: pcQ /_ ae4 10-P_/5- 4'n �� �+ � � ,tC, _ �f��• BUILDI PLANNING &ZONING Reviewed by: Date: 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 05/UM City of Atlantic Beach APPLICATION NUMBER �s r Building Department (To be assigned by the Building Department.) ` 800 Seminole Road 13- Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 Z E-mail: building-dept@coab.us LDate routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 33� h ment review required Yes No Bui iiin Applicant: V V h y-A (— ` k-S anning &Zoning + ^� Tree V`� Atc(L:�*-- minis Fra—to Project: � Pubic Utilities Public Safe-y Fire ices Review fee $ Dept Signature',, / Review or Receipt Date Other Agency Review or Permit Required of Permit Verified B 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: OApproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONINGReviewed by: Date:1 TREE ADMIN. Second Review: ❑Approved as revised. [-]Denied. l APULIC ORKS Comments: L I SE Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. []Denied. Comments: Reviewed by: Date: Revised 05/14/09 rly�,vrl . City of Atlantic Beach APPLICATION NUMBER S Building Department (To be assigned by the Building Department.) Y s 800 Seminole Road �r Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 l E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ! h De artment review re uired Yes No din Planning 8'Zoning Applicant: UV�� ►� ' ree A minis ra or Project: 6 Cie- � 6 G orks ��a�ety Fire Services Review fee $ Dept Signature Review or Receipt Date Other Agency Review or Permit Required of Permit Verified B 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: [ pproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: e 1 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 05/14/09 NOTICE OF COMMENCEMENT Tax Folio No. State of County of t> To Whom It May Concern: ts will Sbemade UT C-t OF Otn rMENCE ANT d m accordance with Section 713 of The undersigned hereby informs you that improvemen the Florida Statutes,the following information is fated m th t i_ ---- �- CA Legal Description of property being improved: _ -- Address of property being improved: C General description of improvements: ---�} ---- 10-w "St- -4- �, A�dress: Owner: fi r 1 -- -- --- - t� _ Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): - Name: Ck- Contractor: Address: _.-'�---L—, - )/[.. Fax No: Telephone No.: v Y— Surety(if any) - -_ — ---_- -- -- -- - Amount of Bond$ Address: -------- Telephone No: -_ Fax No: __ Name and address of any person making a loan for the construction of the improvements Name: ---. ------ Phone ---- Phone No: -_--_____-__-__...__ _ ____-_-- Fax No: _--_ -_.__-- -____ __-___ Name of person within the State of Florida. other than himself, designated by owner upon whom notices or other documents may be served: Name: --__-_---------------------------------------...----- Address: ------------- Telephone No: Fax No: ------ ------ ------ ------ - -_-_______---_-------------__-__ copy provided in Section In addition to himself,. owner designates the following person to receive a co of the Lienor's Notice as p 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Address: --- - ---- ---- --- - -Telephone No: Fax No: __ --------__ --- encement (the expiration date is one (1)year from the date of recording unless a different date-is Expiration date of Notice of Comm specified): _ nw, THIS SPACE FOR RECORDER' 1lQr ')WNERoe I Page 1722. ed:- _ _ ----- — Date: —_-----2013-31-038(),OR BK 1662 da of r 1" /� in the County of Duval,State Dec#20 a afore me thu .3 _ _ Y k �M� --�_ Number Pages:1 — ---- Recorded 12`12`L013 at 10:31 .aM, �Florida,has personally appeared_�—'�s-- u Ronnie`usseU CLERK CiRCU1T COURT DUVRL nary Public at Large.State of Florida C of vat. DOUNTY q commission expireses✓ L __ or RECORDING 510.00 rsonally Known: _ - -- Produced Identification � Notary Public State of Florida .kpBere Lynne Johnson y c` My Commission EE 827455 Expire.0912./2016 CITY OF ATLANTIC BEACH y 800 SEMINOLE ROAD r� ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 r i3 Application Number 13-00003806 Date 1/13/14 � 336 10TH ST Property Address . . . . Application type description DECK/PATIO Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 8000 ----------------------------- Application desc WOOD DECK AND PERGOLA ----------------------------- Contractor Owner --------------- BULL KATHLEEN & NIELS WHYRICK BUILDERS INC 336 10TH ST 4242 LEXINGTON AVE LE FL 32210 ATLANTIC BEACH FL 322335530ACKSO226L3434 -----P ----------ermit . . ELECTRICAL PERMIT Additional desc . PAGEM Sub Contractor ASTERS ELECTRICAL INC . 00 Permit Fee 58 . 60 Plan Check Fee 0 Issue Date Valuation Expiration Date - - 7/12/14 -------------------------------- ------------------ ------------------------- Special Notes and Comments Full right-of-way restoration, including sod, is required. Roll off container company must be on City approved list and container cannot be placed on City Right-of-Way. (Approved: Advanced Disposal, Realco, Shappelle ' s and Waste Management . ) 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC- CODE--------------- ----- - --- ------------------------------------ STATE ELEC DCA SURCHARGE 2 . 00 Other Fees STATE ELEC DBPR SURCHARGE------ 2_00----- ---------------------------------------Paid -----Credited Due Fee summary Charged Permit Fee Total 58 . 60 58 . 60 . 00 . 00 Plan Check Total 00 . 00 . 00 4 . 00 . 00 . 00 Other Fee Total 4 . 00 00 . 00 Grand Total 62 . 60 62 . 60 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 Fax(904) 247-5845 JOB ADDRESS: 23 G 10 �� �� �'r2A."r� ` ,QaA PERMIT# /3 - 0000 3d"04 JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE VALUE OF WORK S 00 NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole ❑Residential(Main)Service ams #of Meters [10-100 amps ❑101-150amps ❑151-200amps P Ll Commercial(Main) Service am s OCT Service amps ❑0-100 amps ❑101-150amps ❑151-200amps ❑ p Conductor Type Size ❑Multi-Family(Main)Service #of Unit Meters [10-100100 amps ❑101-150amps ❑151-200amps LI-amps [I Temporary Pole ❑ amps SERVICE UPGRADE ❑ amps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps 0200amps ❑ amps OCT Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. s 31-31 Outlets/Switches: �_0-30amps p101-101 Appliances: 0-30amps Ps A/C Circuits: 0-60amps 61-100amps Heat Circuits: # circuits @ k Number of Lighting Outlets, Including Fixtures: 3 OTHER ELECTRICAL PROJECTS ❑Transformers KVA ❑Motors hp ❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$ Qty volts/amps REPAIRS/MISCELLANEOUS []Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change OOH to UG ❑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 provisions of any other state or local law regulation construction or the performance of construction. 1�,� ,Qw I / Phone Number Property Owners Name� ���� Of1-7r,4ax Electrical Company Office Phone y'y8 C,r4-//.4!Ai✓ /l Co.Address: �,S/O.2 i'Y14SS�+Gw�,'lL I—J F/. 3•*0/1 City �f� ��A��i�✓ State Zip Certification/Registration#-CA License Holder(Print): —,,,--.— State Notarized Signature of License Holder a ,;�,'f+y SHIRLEY L GRAHAM e e me this daY ° t;OMMISSION#DD 957760 ria,2014 i nature of Notary Publ' '^ ";t d Thru Notary Public Underwriters g