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1253 Selva Marina Cir RES19-0308 Form Board FORM BOARD ELEVATION CERTIFICATE Date (I - z4; - 1 9 Permit Number: KE5 19 - 00 Address: z 53 S�Lv All American Surveyors Work Order # 178 0 3C Required Slab Elevation on City Approved Site Plan: Actual Elevation of Form Board or Grade Stake: l C/vt ,34:,c(? _S Er-i L. •4e- } )3_ 71 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) Q� l� - igety--L w L ,' ( iii. c Y in-Place Density Tests: ENGINEERING, 1 N C Subdivision /Lot Number: /A 5 Sei,,,^ Moo + Cite Geotechnical&itlaterials Engineering and Testing (Address if no lot number) Location Lift/Depth % Max Density _ehn-1-u 6ers'clet- 0- 12 " /00 74 . 5 j Go>„z,. D /L'' f6 A The above tests meet the specification requirements- Pass Fail ❑ (if fail,see notes below) P 9 Notes: This report has not been reviewed by an engineer, _,, the final report can be found at LegacyReports.com w� Date Tested: /2 , R PQR®T S0CQM Tested By: /D � ...--es -- FAST & EASY ONLINE ACCESS 6424 Beach Boulevard, Jacksonville, FL 32216 2904-721-1100 1110 Notice , , , an'I or Treatments - // • Date of Inspection Date of Treatment drtrki I) 7044 Pesticide Used �Wf»i k 11itrrt L, ac Wood-Destroying Organism Treated Pursuant to Section:105.10 of the Florida Building Code,this notice is required to be posted.Any licensee who performs control of any wood-destroying organism shall post notice of said treatment immediately adjacent to the accesss to the attic or crawl area or other readilyilaccessible area of ty ProP.5 4 4, rt-G4--!'v( ad"Tr," - HomeTeam PEST DEFENSE' 6694 Columbia Park Dr S Ste 3 Jacksonville,FL 32258 904-730-2522 8553-09/16