1945 SEMINOLE RD PLRS21-0179 - moi' iii,,, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
1 '� PLRS21-0179
"" CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 12/7/2021
'!�;ss�� V ATLANTIC BEACH, FL 32233 EXPIRES: 6/5/2022
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:
1945 SEMINOLE RD PLUMBING RESIDENTIAL PLUMBING - 3 FIXTURES $1200.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: I NUMBER: GROUP:
169542 0518 BEACHSIDE
{
COMPANY: ADDRESS: CITY: STATE: ZIP:
ALL FIX N CLEAR 1545 CRABPPLE COVE CT N JACKSONVILE FL 32225
PLUMBING, LLC
>, .OWNER: i ADDRESS: CITY: STATE: ZIP:
LIVINGSTON REBECCA 455 SELVA LAKES CIR ATLANTIC BEACH FL 32233-5917
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.
USTOF CONDITIONS, ..
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
I
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322 1000 3 $21.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2 00
TOTAL:$80.00
Issued Date: 12/7/2021 1 of 2
,-;----:_\4:1,------.7,3„ PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS21-0179
� ��. 800 SEMINOLE ROAD
ISSUED: 12/7/2021
\r ss • EXPIRES: 6/5/2022
ATLANTIC BEACH, FL 32233
Issued Date: 12/7/2021 2 of 2
Plumbing Permit Application **ALL INFORMATION
�� HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 F L R S Z( - O(/9
Phone: (904) 247-5826 Email: PERMIT#: 1` 5 ra-\ ° ya
JOB ADDRESS: 1945 Seminole Rd.Atlantic Beach, Fl 32233 PROJECT VALUE $1200
✓INEW OR REPLACEMENT INSTALLATION and/or EIRE-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 Bibs Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater 1
Other Fixtures 1 Water Treating System
❑MISCELLANEOUS
['Sewer Replacement
['Back Flow Preventer
0 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. **
DOther
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:Rebecca Livingston Phone Number: 904-993-6988
Plumbing Company: All Fix n' Clear Plumbing Office Phone: 9046879821 Fax
Co. Address: 1545 Crabapple Cove Ct. N. City: Jacksonville State: FI32225 Zip:
License Holder: Enrique L. Dela Cruz Jr. t to Certification/Registration # CFC1429636
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this day of A°_e.44...46-c, 20 N, in the State of Florida,
County of p V vl,t
FAZILAMIRAJUDDIN Signature of Notary Pu•
,L • Commission#GG 349540
lmtl :0:
;;,.,� ; Expires June 27,2023 [ ) Personally Known OR •rodu•-d Identification
'' Bonded Thru Troy Fain Insurance 800-385.7019 Y'
Type of Identification: /'
Updated 10/17/18