751 Sailfish Dr PLRS21-0191 Sewer Replacement (r.:(1-"'41:4-1iPLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
��"� 1 CITY OF ATLANTIC BEACH PLRS21-0191
'�' ISSUED: 12/20/2021
\ 800 SEMINOLE ROAD
'`�P:'i9r ATLANTIC BEACH. FL 32233 EXPIRES: 6/18/2022
MUST CALL INSP CTION PILO ' i 47-5814B` 4 PM C ' 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: I PERMIT TYPE: j DESCRIPTION: VALUE OF WORK:
751 SAILFISH DR PLUMBING RESIDENTIAL Sewer Replacement $900.00
TYPE OF i REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: I NUMBER: i GROUP:
171235 0000 ROYAL PALMS UNIT 01
COMPANY: I ADDRESS: CITY: STATE: I ZIP:
JOHN MOON PLUMBING 1103 PALM CIR JACKSONVILLE FL 32250
BEACH
OWNER: I ADDRESS: CITY: STATE: ! ZIP:
SAILFISH DR FAMILY TRUST C/O MICHAEL MANGANI ATLANTIC BEACH FL 32233
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.
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
L
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 1 $7.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$66.00
Issued Date: 12/20/2021 1 of 2
"'`'f PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
,,:i 1�
-,. RJ PLRS21-0191
a V� CITY OF ATLANTIC BEACH ISSUED: 12/20/2021
800 SEMINOLE ROAD
''-'• t1 ATLANTIC BEACH. FL 32233 EXPIRES: 6/18/2022
Issued Date: 12/20/2021 2 of 2
Plumbin Permit Application **ALL INFORMATION
t�.:L�;�� g Mp HIGHLIGHTED IN
- City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 � �v�2 rQ/9
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: L / /
-
JOB ADDRESS: 5 ) ; )C 0; ' 1 • PROJECT VALUE $ 943 ' IV
❑NEW OR REPLACEMENT INSTALLATION and/or ORE-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 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS
['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: ,l/c-A9 ///i iucii vl Phone Number: oMYZ
Plumbing Company: ,496✓ / �'? MerVIV/%*-4I e Phone: ox -_-.2,7y__2-75,3x
Co. Address: Z 'ci7. Cies (7A—i) City: // % State:A„ Zip: 322_713
License Holder: ; V\ feta dh ! State Certification/Registration# r!,fG c)/9,,Z
Notarized Signature of License Holder /rei_vi fr)
The foregoing instrument was acknowled ed before me this day of 0 EC. _ , 20 2), in the State of Florida,
County of in Vi L.
Signature of Notary Public 4/1
CHRISTIANGILES [ I Personally Known OR [Wroduced Identification
:.: ;.; MY COMMISSION#HH117153 Type of Identification: L- D. L _
c apo EXPIRES:April 13,2025
Bonded TAru Notary Pubic Underwriters Updated 10/17/18