2075 Vela Norte Cir PLRS21-0089 Add Plumb Fixtures Revision Revision Request/Correction to Comments **ALL INFORMATION
HIGHLIGHTED IN
f J'_ City of Atlantic Beach Building Department GRAY IS REQUIRED.
V
800 Seminole Rd, Atlantic Beach, FL 32233 /�
10/ Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:/42.52 1-00697
Revision to Issued Permit OR Corrections to Comments Date: c_/ y'2227
Project Address: 2&?5 G/e/4 //f,tie A`h Bc..4 /;/ 3 Z Z z 3
Contractor/Contact Name: 4-1.401^ // ✓�.zt l
Contact Phone: (qoy) WC- llJ/ f Email: / .17,1 o-a cS 6y7
Description of Proposed
Revision
,//Corrections: / / /
I /7,,,.L/ Tvr affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• W,illroposed revision/corrections add additional square footage to original submittal?
0-No ❑ Yes (additional s.f.to be added:
• Will proposed revision/corrections add additional increase in building value to original submittal?
❑No ❑*Yes (additional increase in building value: $ ) (Contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
(Office Use Only)
❑ Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$
Revision/Plan Review Comments
Department Review Required:
Building
Planning&Zoning Reviewed By
Tree Administrator
Public Works
Public Utilities
Public Safety Date
Fire Services Updated 10/17/18
C'yL4, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
"' PLRS21-0089
CITY OF ATLANTIC BEACH
v~ 800 SEMINOLE ROAD ISSUED: 6/3/2021
"�:ti>r ATLANTIC BEACH, FL 32233 EXPIRES: 4/8/2022
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
Plumb 10 Fixtures: 2
2075 VELA NORTE CIR PLUMBING RESIDENTIAL BATHROOM REMAKE / $2000.00
REMODEL
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169506 1088 SELVA NORTE UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
CALL PLUMBING INC 5436 KENNERLY RD JACKSONVILLE FL 32207
OWNER: ADDRESS: CITY: STATE: ZIP:
HEALY GRANT A 2075 VELA NORTE CIR JACKSONVILLE FL 32233-4533
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
g: FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 0 $0.00
PLUMBING FIXTURES 455-0000-322-1000 4 $28.00
PLUMBING FIXTURES 455-0000-322-1000 6 $42.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
Issued Date: 6/3/2021 1 of 2
PlumbingPermit Application
**ALL INFORMATION
rs""L���. HIGHLIGHTED IN
J ��' City of Atlantic Beach Building Department GRAY IS REQUIRED.
`'*p'' 800 Seminole Rd, Atlantic Beach, FL 32233 P� }� S 2 - 0 � 9
0;09,' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 24275— I44a 4(,) ,--/-_, -'" ? 5' OJECT VALUE $ // 7:5 ')
--
El NEW OR REPLACEMENT INSTALLATION and/or El RE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan /
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet /-
Hose
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory —/— Water Heater
Other Fixtures Water Treating System
El MISCELLANEOUS
U Sewer Replacement
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler heads)
❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Well **SJRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection. **
❑ 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.
Owner Name: /"ea"/K Phone Number:
Plumbing Company: C/1-LG f ,,u47)----5 Office Phone( Oy)86' 69/ Fax
Co. Address: 3-9/Y6 4,r4n-ri7j 47 City:✓;v( State:r(Zip: 32 26) 7
License Holder:
Owner `/ J 0 zi e f State Certification/Registration #CFC 05-688
Notarized Signature of License Holder �_-'1,
The foregoing instrument was acknowledged before me this 3 day of OCT , 20 LI , in the State of Florida,
County of tb 'VAL
Signature of Notary Public CIMA,0-:(.20"-^-- /V-A:1----1
(:::!:: # LPersfoldneanllyt.f.Knotw.on roducerdIdntification
_ _:oMYEXPIRSS13COMMISSIONHH2025117153 T( OR FL 1) , e
.RM;°''' Bonded Tlru Notary Pubic Underwdtsrs
Updated 10/17/18