2233 Seminole Rd Unit 12 PLRS22-0008 6 fixtures permitOWNER:ADDRESS:CITY:STATE:ZIP:
PETWAY BRETTE 1535 UPLAND AVE BOULDER CO 80304
COMPANY:ADDRESS:CITY:STATE:ZIP:
MIKE SANVILLE PLUMBING
INC 5627 Verna Blvd. #3 JACKSONVILLE FL 32205
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169519 0124 OCEAN VILLAGE ONE
CONDO
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
2233 SEMINOLE RD UNIT 12 PLUMBING RESIDENTIAL 6 FIXTURES - REMODEL $4000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 6 $42.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $101.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 1/11/2022
PERMIT NUMBER
PLRS22-0008
ISSUED: 1/11/2022
EXPIRES: 7/10/2022
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 1/11/2022
PERMIT NUMBER
PLRS22-0008
ISSUED: 1/11/2022
EXPIRES: 7/10/2022
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Plumbing ApplicationAlication ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
lc l
800 Seminole RdAtlantic BeachFL 32233 p LR S Z Z -OXi/
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: a I- 001-r
JOB ADDRESS: {; .2 s3 501/ i\AU?IAC. (A It/ PROJECT VALUE $ 1U00
NEW OR REPLACEMENT INSTALLATION and/or RE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet I
Hose Bibs Urinal
Kitchen Sink 1-- Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Z. Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS LOuSewerReplacement
Back Flow Preventer
Lawn Sprinkler System (number of sprinkle ea•
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: 6.6T-e [9- (a7 Phone Number:
Plumbing Company: mr/ e. 5rtik. .)1 i (' (/ ).Office Phone: "-. ''OHO (I Fax
Co. Address: S6 27 VQ./,(rt Y'I y;/ Pk S City: .. ../21 ... State:6 Zip: TaNO-C—
License Holder: ,/' Z?ke S 4 /LC/I(,'C_ State C ification/Re stration #C_FCQ c-7 'L/ 3
Signature ofLicense HolderNotarizedg 77/1.64,
The foregoing*' trument was cknowledged before me this ( day : ---SQ 20 2 ;irrthe State of Florida,
County of U /c.
Signature of Notary Public '—Q _ ' CL
PUf„y••4'G•• Oidl SPERGER
41:::', I iY COMMISSIONN#GG 353178 ersonally Known OR [ ] Produced Identification
i`-, • :' EXPIRES:October 6,2023 Type of Identification:
I_'. F`°`•° Bonded Thru Notary Public—....
a"--------UnderwritersUpdated 10/17/18