380 12th St Density Test, Form Board LEGACY In-Place Density Tests: OFFICE COPY
)ENGINEERING, INC Subdivision /Lot Number: �j/E yiY
Georech"-1&Mara1a4 Engineering and nudng (Address if no lot number)
Location Lift/De th "/.Max Densi
r—•
The above tests meet the specification requirements—Pass tJ Fail O (ifrmt=notr,bel.„.)
Notes:
This report has not been reviewed byan engineer, LEGACY
the final report can be found at LegacyReports.com
Date Tested: /_,/� REPORTS.COM
Tested By: —S.L FAST& EASY ONLINE ACCESS
6424 Beach Boulevard, Jacksonville, FL 32216 -904-721-1100
OFFICE COPY
FORM BOARD ELEVATION CERTIFICATE
Date 6-- l - / 7 Permit Number:
NGT 1Po5 (e 1J
CA-
Address: 380 /,a-" sT
All American Surveyors Work Order # /7 .2 Y31
Required Slab Elevation on City Approved Site Plan:
L// GG - )
Actual Elevation of Form Board or Grade Stake:
Survey Company:
ALL AMERICAN SURVEYORS OF FLORIDA INC.
3751 San Jose Place, Suite 15
Jacksonville FL 32257 Work Phone: 904-279-0088
Signature of Surveyor:(PartyChief)
DOenalgn Envelope ID:8482 CD$2213413AF-93BE-ASAB3594D51)9 OFFICE COPY
LUCAS&SCOTTENGI NEERI NGINc
12827 San Jose Boulev.m,Su Bm•JaG twill.,Flonda 32223
Douglas V.Lucas,P.E.
Licemed in FL
Cf (904)2890
F 221571
ug
tlo@LucaeSeot.wMcoC.com
April 18,2019
REVIEWED FOR CODE COMPLIANCE
City of Atlantic Beach CITY OF ATLANTIC EEACH
Building Department SEE PERMITS FOR ADDITIONAL
800 Seminole Road REQUIREMENTS AND CONDITIONS
Atlantic Beach,Florida 32233 �
REVIEWED BY: rYll DATE: 3/2y Q'
Re: Pollack Residence,380 12*Street,Atlantic Beach,Florida,Engin ering Job No.
JAL,POLLACR,Design Modification 1—Stemwall Footing Rebar
To Whom It May Concern:
1. It is acceptable to bend the vertical rebar into the slab at the top of the stemwall.
The engineering changes to the subject project are structurally satisfactory. If you require any
additional information,please do not hesitate to contact me.
Sincerely,
Douglas V. Lucas
Structural Engineer
...............
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04-18-2019