1496 Camelia Street PLRS22-0138 PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLR522-0138
n 800 SEMINOLE ROAD ISSUED:9/16/2022
++" ATLANTIC BEACH. FL 32233 EXPIRES: 3/15/2023
ALL • • • • • • • • • • • • • • • •
CODE, NEC, IPIVIC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
FNOTICE- n addition to therequirements of this permit,there may be additional restrictions applicable to this property
be found in the public records of this county,and there may be additional permits required from other
ntal entities such as water management districts,state agencies,or federal agencies.
JOB ADDRESS: r • OF • '
1496 CAMELIA ST PLUMBING RESIDENTIAL PLUMB REPIPE II $8000.00
FIXTXTURES
TYPE OF ZONING: ' : r
CONSTRUCTION: NUMBER: GROUP:
171078 0100 ATLANTIC BEACH SEC H
COMPANY: ADDRESS:
Snyder Co dba SNYDER PO BOX 16826 JACKSONVILLE FL 32245
HEATING &AIR
OWNER: ADDRESS:
CREGAR BRENDA E 1496 CAM ELIA ST ATLANTIC BEACH FL 32233-1849
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IS
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455 0000-3221000 0 $55.00
PLUMBING FI%TURES 455-0000-222-ION 11 $71,00
STATE DBPR SURCHARGE 455-0000-208-0100 0 $3.63
STATE EGA SURCHARGE 455-MM 208-0600 0 $2.42
WORK WITHOUT PERMIT 455-0000-322-1000 0 $11000
Issued Date:9/16/2022 1 of 2
•`ALL INFORMATION
Plumbing Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY Is REQUIRED.
800 Seminole Rd,Atlantic Beach, FL 32233 PL.RS-Z-(7138
Phone: (904) 247-5826 Email: Buildin -Det coab.us PERMIT#�:
y
JOB ADDRESS: t Q--� PROJECT VALUE$ fi
000
04EW OR REPLACEMENT INSTALLATION and/or 63RE-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
01v11SCELLANEOUS
[]Sewer Replacement
❑Back Flow Preventer
[]Lawn Sprinkler System (number of sprinkler heads)
urease Interceptor(Trap) gallons(Requires 3 sets of plans)
[]Well "•S1RwD 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.
- �I 1�r��
Owner Name.Lae,ndA h r Phone Number: ,�„U1 —344?) —
Plumbing Company:SYll ky Co Office Phone: Fax
Co.Address:_* 1 suk"at1�;\Vii. City:-TfICLk9[)lAffll6�_State: 0, Zip: WI1 RO
License Holder. State Certification/Registration a
Notarized Signature of Ucense Holder
The foregoing instrument was acknowledged b /Ie this day of�� . 20.77- in the State of Florida,
County of 'Pv-v&l /
Signature of Notary Public 17L-- Z�`�0�n'�
.4e.wN,: #MEN G.RONDERSDN [7 Personally Known OR[ ] Produced Identification
Cam Nl-!o 0HN061903
wn�:`Erpims Haroe7,2p26 Type of Identifications
eona,a m„rm r#nmwmeooaNsrau Ua�1011x/ia