325 Garden Ln - Siding Permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
oll 9, INSPECTION PHONE LINE 247-5814
RESIDENTIAL -ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0248
Description: NEW SIDING
Estimated Value: 27000
Issue Date: 11/13/2017
Expiration Date: 5/12/2018
PROPERTY ADDRESS:
Address: 325 GARDEN LN
RE Number: 1720205058
PROPERTY OWNER:
Name: FORD CURTIS R
Address: P 0 BOX 331443
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Age In Place, Inc.
Address: 6748 Little Rain Lake Rd
Keystone Heights, FL 32656
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
:r City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 7
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us I
APPLICATION REVIEW AND TRACKING FORM
Property Address: Gccf'der\ L ov,e Dp_partn]ent review required Yes -No
'Building___--�
Applicant: e__ Pigo e - -9fanning &Zoning
Tree Administrator
Project: C L Sl� r\-)C' 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:
APPLJCATION STATUS
Reviewing Department First Review: proved. [:]Denied. []Not applicable
(Circle one.) Comments:
EE9
PLANNING &ZONING Reviewed by: Date-.//- f
TREE ADMIN. Second Review: FlApproved as revised. F]Denied []Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [:]Approved as revised. ElDenied. F]Not appiicabie
Comments:
Reviewed by: Date:
Revised 05/19/2017
Building Permit Application
City of Atlantic Beach OFFICE COPY
800 Seminole Road, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: D.5 6t,.4e,,Lar%e,, F-11, 1.1133 Permit Number:-RES17- 04q&
Legal Description ;I-9q Ol-IS 9qE �4,a Wva4 6mile, 31 FT LoA n VJ)OTLA16 RE# [_�)0)0 -��C>S
Valuation of Work(Replacement Cost)$ d? 060,0 Heated/Cooled SIF /Sto � Non-Heated/Cooled
• Class of Work(Circle one): New Addition Clte�__D Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial =Residentfial"
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: 4-t,�6a^3 0.%k t_
SIZ)2q 0
Florida Product Approval# for multiple products use product approval form
PropertV Owner lnforWtion
-)�
L
Name: �,vjks Address: Pc) 0
City. State Ft zip g-?:)-,-I? —Phone (a
E-Mail 4�-q
Owner or"Xgent(If Agent., Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: A4 e 1-4 &,e- 1�q e- Qualifying Agent:
Address i Ll W-e U.., &�x Z, City 4z,,NI1;zA, State ri zip 3--)&�-L
Office Phone 9tl- Job Site/Contact'N umber
State Certification/Registration# C6,� ,S-A 6,C,eto E-Mail �A"
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Z I-.?1((K
Ex;mpt/Insurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated. I 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 the laws regulationg
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS, and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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
RECORPNG YOUR NOTICE F COMMENCEMENT
40
Signature of Owner or Ageneincluding Contractor) (Signature of Contractor)
Sit d do sworn to affirmed)before me thks d of S11 ed and sworn to(or_affirme�qLbefore me this 4-3day of
by by �T�kVVYz�:S Hq V)
N
MARGAF(6tRp0A*f No
Y Notary Public-S_ Vlorida MARGARET Ft.O�Vl�
0
tate 0
kT
0�ir MY COMM.Expires Aug 25,2018 OY Notary Public-State btflorida
Co
mmission # FIF 119727 My Comm.Expires Aug 25,2018
PersonAlly Known,-(A Commicsion # FF 119727
�erso d1l RM01 a RIP
Produced Identification KProduced Ident icati
Type of Identifi T)i 71-S,
Type of Identification: cation: L
,,- er
llal-mq� -'-;L OFFICE COPY
NOTICE OF COMMENCEMENT
State of 4)0 Tax Folio No.
County of
To Whorn 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.
Le I-r—"eser4ption-of-pr-operty-being-imprave
. �q rl IA�L
Address of property being improved: -�al�-82j
General description of improvements: _Jearofr oaL f�vv-,_
Owner: C,,r4��, Address: JPjS0q. 29043
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: A-/- Ta ALe- 7Z:,tC__
wv�ddress:V_ G-NZ k4k\�,,
TelephoneNo.: Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
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:
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:
Address:
Telephone No: Fax No:
MAR 'ARET R Q is
Expiration date of Notice of Commencement(the expi ration date is one (1)year fftrom t -OVA%Ngea it- 11106"W
specified): My Comm-Expir@
Commission #FF 119727
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: Date: to ?-b
in Ais a of in th Co nty 6f Duval,State
Doc#2017248360,OR BK 18168 Page 228, Before e is 31 - V_
'Of Florida,has personally appeared
Number Pages: 1 [Notary Public at Large,State Qf Flori'da,Coun of Duval.
Recorded 10/31/2017 02:43 PM, My c . . 5
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL ires:
-COUNTY 111'e-rsonally Known: or
o uce o i1cation,
RECORDING $10.00
OFFICE COPY
HARDIPLANK. LAP SIDING
INSTALLATION INSTRUCTIONS James Hardie
JUNE 2001
RUSTIC CEDAR@* SELECT CEDARMILLz - SMOOTH - COLONIAL SMOOTH@ - COLONIAL ROUGHSAWN®R
BEADED CEDARMILL * BEADED SMOOTH 9 STRAIGHT-EDGE SHINGLE PLANK@
IMPORTANT: FAILURE TO INSTALLAND FINISH HARDIPLANKIRI IN ACCORDANCE WITH APPLICABLE BUILDING CODE COMPLIANCE
REPORTS AND JAMES HARDIE'S WRITTEN APPLICATION INSTRUCTIONS, MAY AFFECT SYSTEM PERFORMANCE,VIOLATE LOCAL
BUILDING CODES REQUIREMENTS,AND VOID THE PRODUCT ONLY WARRANTY.
HANDLING &STORAGE: CUTTING OPTIONS:
Store flat and keep dry prior
to installation. Installing
siding wet or saturated may
result in
shrinkage Circular saw with Circular saw blade Electric or pneumatic Pneumatic Carbide score and
at butt dust collector with carbide-tipped teeth hand shear shear snap knife
joints. 1�
Carry planks recommends Makita@#5044KB 4"or#5057KB 7-1/4"saw with dust collection.Call 800-4MAKITA.
on edge. Hitachi@ HARDIBLADEO w/4 PCD Diamond Teeth.Call Hitachi@ at 800-546-1666 for nearest dealer.
SNAPPER SHEAR-electric.pneumatic,or hand shear.Call 800-297-7487 for tool information.
Always wear safety glasses and dust protection when operating power tools.For more information on avoiding inhalation
referto the MATERIAL SAFETY DATASHEET available whereverJames Hardie fiber-cement products are sold.
FRAMING REQUIREMENTS:
Hardiplank lap siding can be installed over braced wood
or steel studs spaced a maximum of 24"o.c.or directly to figure 1 Double Wall Single Wall
minimum 7/16"thick OSB sheathing. Hardiplank lap siding Construction Construction
can also be installed over foam insulation up to 1"thick.t weather-resistive barrier 16"o 24"
Irregularities in framing,sheathing,and/or foam insulation let-in bracing
can mirror through the finished application.A weather- plywood or on ce ter
resistive barrier is required*. Install Hardiplank siding with OSB sheathing
joints butted in moderate contact.Optionally,install the
lap siding with a maximum 1/8"gap and
caulk the joint**(see detail at right), Blind nailing Hardiplank
The first course of any wall stud 1"from
should be installed over a 1/4" weather-resistive
lath strip to ensure a consistent barrier plank top
plank angle(see figure 1),
3/8"from
plank edge
.0
0
0
A-
0
0 '0 weather-resistive
TFor application over foam insulation, 0 barrier
the length of the specified fastener moderate contact,or 00 OD 00
shall be increased by the thickness maximum 1/8"gap 0 0
of the foam insulation. 0 fastener
*Use a weather-resistive barrier in accordance with:BOCA leave 1/8"gap between 1/4"thick
National Building Code Section 1403.3:SBCCI Standard Building plank and trim,then caulk lath strip
Code Section 2303.3;lCB0 Uniform Building Code Section 1402.1:or
CABO One-and-Two Family Dwelling Code Section 703.2.1.
NOTE�Some Building Codes exempt the use of weather-resistive barriers over James Hardie's seal of approval
"water-repellent panel sheathing or exterior panels classified as"weather-resistive indicates products recommended
barriers".James Hardie recommends the use of"building paper type"weather-
resistive barriers with all siding products.James Hardie will assume no responsibility for use by James Hardie Building
for water infiltration within the wall. Products
WARNING: AVOID BREATHING SILICA DUST
Product contains Silica. Inhalation of respirable silica dust can cause silicosis a potentially disabling lung disease,and is known to the State
of California to cause lung cancer.When drilling,cutting,or abrading product during installation or handling. (1)Work outdoors where
feasible,otherwise use mechanical ventilation, (2)Wear a dust mask or, if dust may exceed PEL, use NIOSHI approved respirator,
(3)Warn others in area, For further information, refer to material safety data sheet or consult employer.
FAILURE TO ADHERE TO WARNINGS, MSDS,AND INSTALLATION INSTRUCTIONS MAY LEAD TO SERIOUS PERSONAL INJURY.
GRADECLEARANCE figure2 ROOFCLEARANCE figure3 CONCRETE CONSTRUCTION figure 4
Install Hardiplank@ siding in At the juncture of the roof and vertical sur- Hardiplank siding can be installed directly to masonry
compliance with local Building Code faces,flashing and counterflashing shall be block. Hardiplank siding can also be installed to concrete
requirements for clearance between provided per the roofing manufacturer's construction,when the wall is furred out with wood fra-
the bottom edge of panel/framing and instructions. Provide a 1"-2"clearance ming or minimum No.20 gauge steel framing anchored
the adjacent finished grade. between the roofing and bottom edge of to the wall.Framing can be spaced up to 24"OC.Consult
stud siding or as recommended by the roofing National Evaluation Service report NER-405 for recog-
weather-res'sfive manufacturer. nized applications to masonry block and wood or metal
barrier 1 2" framing.A weather-resistive barrier is recommended
between the framing and the siding.
concrete
foundation
weather-
resistive
barrier
1/4"thick Hardiplank
in
lath strip lap siding tnominal 2"x 2"
" 'i f,
flashing I wood furring
FACE NAIL figure 5 BLIND NAIL figure 6
Corrosion Resistant Nails(galvanized or stainless steel) Corrosion Resistant Nails(galvanized or stainless steel)
6d(0.118"shank x 0.267"HD x 2"long) Siding nail(0.089"shank x 0.221"HID x 2"long)**
Siding nail(0.089"shank x 0.221"HID x 2"long) 11ga.roofing nail (0.121"shank x 0.371"HID x 1 1/4"L)
Siding nail(0.091"shank x 0.221"HID x 1 1/2"long) ET&F PanelfaStT11 (0.100"shank x 0.25"HID x 1 1/2"long)**
ET&F pin(0,100"shank x 0.25"HD x 1 1/2"long)** Corrosion Resistant Screws
Corrosion Resistant Screws -Ribbed Bugle-head or equivalent(No.8-18 x 0.375"
Ribbed Bugle-head or equivalent(No.8-18 x 0.323"HID x 15/8" HID x 1 1/4"long)Screws must penetr e I
long)Screws must penetrate 1/4"or 3 threads into metal framing. threads into metal framing. tFRCE COPY
For face nail application of 9 1/2"wide or less siding to CSB,fasteners are spaced a maximum of 12"o.c.
The use of a siding nail or roofing nail may not be applicable to all installations where greater windloads or higher exposure categories of wind
resistance is required by the Local Building Code.Consult the applicable Building Code Compliance Report.
figure 5 figure 6
stud 16"or 24"
0.c stud 16"o.c.
weather-resistive max.
1 1/4"min, barrier
overlap
face nail blind nail
3/4%1
Minimum overlap
J for Both Face
and Blind Nailing
weather-resistive
1 1/4' min. barrier*
eather-resistive ove lap space plank according to
barrier min. 1 1/4" J
p joint treatment with a 1/8"
space plank according to ove�jrlap
maximum gap
joint treatment with a 1/8"
maximum gap
PNEUMATIC FASTENING: FASTENING REQUIREMENTS:
Hardiplank siding can be hand nailed or fastened with the Drive fasteners perpendicular to siding and framing.
use of a pneumatic tool.Set your air pressure so that Fastener heads should fit snug against siding(no air space), (Fig.A&B)
the fastener is driven snug with the siding surface. Do not over-drive nail heads or drive nails at an angle.
DO NOT If nail is countersunk,caulk nail hole and add a nail.(Fig.C)
RECOMMENDED: STAPLE
Use a flush mount attachment on pneumatic tool.This will Countersunk,
help control the depth that the nail is driven.This will be Snug K'Ds Flush Caulk&
especially helpful when more than one pneumatic tool is add nail
driven off the same compressor. Q7 9 do not under
figure A figure B figure C drive nails
NAIL TYPE:
Fasteners must be corrosion resistant,galvanized or stainless steel. Electro-galvanized nails are acceptable for use with James Hardie Siding
Products,but may exhibit premature corrosion.James Hardie recommends the use of quality,hot-dipped galvanized nails.(James Hardie is not
responsible for the corrosion resistance of fasteners.)
The EZ Line assists in a 1-1/4
overlap alignment, and with placing
weather-.resistive the nail at the required placement.
barner*
EASY 1-2-3 INSTALLATION
1) Install 1/4" lath strip to ensure
consistent plank angle.
0
1/4"overlap 2) Fasten Hardiplank siding with EZ Line
o EZ Line over 1/4"lath strip.
alignment aid OFFICE COPY
o 3) Overlap second piece of Hardiplank siding
with EZ Line 1-1/4",utilizing
o o Hardiplankl&siding EZ Line alignment aid.
1/4"thick with EZ Line
lath strip
FASTENING AND SPACING HARDIPLANK SIDING WITH EZ LINE
FACE NAIL: Nail 3/4"-1"up from bottom of plank BLIND NAIL: Nail 1"down from top of plank
Fasten 16"o.c. (All Lap Products) Do not use JH logo for nailing guide
Moderate contact or maximum 1/8" Fasten 16"-24"o.c.
gap and caulk the joint Moderate contact or maximum 1/8"
gap and caulk the joint
1 1/4"overlap EZ Line
stud 16"or 24" alignment aid
O.C. stud 16"or 24
11/4"min. O.C.
overlap 1 1/4"min.
face overlap
blind nai
weather-resistive
bamer* weather-resistive
space plank according to barrier
joint treatment with a 1/8" space plank according to
maximum gap joint treatment with a 1/8"
maximum gap
SPACING STRAIGHT EDGE SHINGLE PLANKC
0 weather-resistive Proper Handling Impro
barrier
P Han"411;q
e7rdling
40
16"or
24"
o.c 1 Install 1/4"lath strip to ensure consistent plank angle.
2) Begin first course at end of far left wall and nail to stud.
3) Second course begins at the next stud(116"or 24")to the right
4) Third course begins by moving to the next right stud(16"or 24")
from secound course.
4) Fourth course begins by moving to the next right stud(116"or 24")
1/4"thick lath st from third course.
0 rip 0 6) Fifth course moves back to first stud(#2)and the sequence continues.
COVERAGE CHART/ESTIMATING GUIDE
1. Figures shown are in pieces-all 12' long 2. 5%cutting and fitting waste factor included OFFICE COPY
3. Computations based on minimum overlap of 1-1/4"4. Actual usage subject to variables such as building design and
installers
COVERAGE AREA ;
LESS HARDIPLANKO SIDING WIDTH
OPENINGS 5-1/4" 6-1/4" 7-1/4" 7-1/2" 8" 8-1/4" 9-1/4" 9-1/2" 12"
(exposure) (4") 5") (6") (6-1/4") (6-3/4") (7") (8") (8-1/4") (10-3/4")
100 sf 1 SQ 26 21 18 17 16 15 13 13 10
200 sf 2 SQ 53 42 35 34 31 30 26 25 20
300 sf 3 SQ 79 63 53 50 47 45 39 38 29
400 sf 4 SQ 105 84 70 67 62 60 53 51 39
500 sf 5 SQ 131 105 88 84 78 75 66 64 49
600 sf 6 SQ 158 126 105 101 93 90 79 76 59
700 sf 7 SQ 184 147 123 118 109 108 92 89 68
800 sf 8 SQ 210 168 140 134 124 120 105 102 78
900 sf 9 SQ 236 189 158 151 140 135 118 115 88
1000 sf 10 SQ 263 210 175 168 156 150 131 127 98
1100 sf 11 SQ 289 231 193 185 171 165 144 140 107
1200 sf 12 SQ 315 252 210 202 187 180 158 153 117
1300 sf 13 SQ 341 273 228 218 202 195 171 165 127
1400 sf 14 SQ 368 294 245 235 218 210 184 178 137
1500 sf 15 SQ 394 315 263 252 233 225 197 191 147
1600 sf 16 SQ 420 336 280 269 249 240 210 204 156
1700 sf 17 SQ 446 357 298 286 264 255 223 216 166
1800 sf 18 SQ 473 378 315 302 280 270 236 229 176
1900 sf 19 SQ 499 399 333 319 296 285 249 242 186
2000 sf 20 SQ 525 420 350 336 311 300 263 255 195
2100 sf 21 SQ 551 441 368 353 327 315 276 267 205
2200 sf 22 SQ 578 462 385 370 342 330 289 280 215
2300 sf 23 SQ 604 483 403 386 358 345 302 293 225
2400 sf 24 SQ 630 504 420 403 373 360 315 305 234
2500 sf 25 SQ 656 525 438 420 389 375 328 318 244
2600 sf 26 SQ 683 546 455 437 404 390 341 331 254
2700 sf 27 SQ 709 567 473 454 420 405 354 344 264
2800 sf 28 SQ 735 588 490 470 436 420 368 356 273
2900sf 29 SQ 761 609 508 487 451 435 381 369 283
3000 sf 30 SQ l� 788 630 525 504 467 450 394 382 293
FINISHING SIDING: Caulking: Painting:
A high quality,paintable caulk is recom- James Hardie products must be painted.For best results
Patching: mended. For best results use caulks that install Hardiplank siding with our exclusive Prime Plus"
Dents,chips and cracks can be factory priming system and a 100%acrylic topcoat(s).*If
filled with a cementitious comply with either ASTM C 834 or ASTM our Prime PIUSTM factory priming is not being used,Hardie
patching compound. C 920.Caulking should be applied in recommends the application of an alkali-resistent primer
accordance with caulking manufacturers along with 100%acrylic topcoat(s).
written instructions,(leave 111"gap at trim (For paint manufacturer's paint
specifications,refer to JH
for caulk.Caulking at butt joints is optional Technical Bulletin No.S-100.)
CEMENT *Note:Please refer to paint
PATCH manufacturers'specifications for
CAULK application rates.
APPROVALS:HARDIPLANK lap siding is recognized as an exterior wall cladding in National Evaluation Report No,NER405:City of Los Angeles,Research
Report No.24862;Dade County,Florida,Acceptance No.99-0223.07,US Dept.of HUD Materials Release 1263a,California DSA PS-019 and City of New York
MEA 223-93-M.These documents should also be consulted for additional information concerning the suitability of this product for specific applications,
Corporate Headquarters For Technical Assistance,IVISDS,
26300 La Alameda,Suite 250 and Product Information
Mission Viejo,CA 92691 Call 1-800-9HARDIE
@ 2000 James Hardie Building Products (1-800-942-7343) James Hardid"
Printed in USA www.jameshardie.com JH91513SL 06/01
Cash Register Receipt Receipt Number
City of Atlantic Beach R3613
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $55.00
RES17-0248 Address: 325 GARDEN LN APN: 172020 5OS8 $55.00
SIDING IN PROGRESS 12/01/2017 RBE $55.00
SIDING IN PROGRESS 12/01/2017 RBE 1 45500003221002 0 $55.00
TOTAL FEES PAID BY RECEIPT: R3613 $55.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
12/05(2017 13:13:40
CREDIT CARD
VISA SALE
Card XXXXXXXXXXXX6124
SEQ#: 3
Rath#: 496
INVOICE 3
Approval Code: 061666
Entry Mdod: Manual
Mode: Online
Tax Amount: $0.00
Card Code: M
SkE AMOUNT �55-00
CUSTOMER COPY
Date Paid:Tuesday, December 05, 2017
Paid By: Age In Place, Inc.
Cashier: BA
Pay Method: CREDIT CARD 3
0,0,%
Printed:Tuesday, December 05,2017 1:20 PM 1 of 1 6-
T 17