548 N NAUTICAL BLVD IRR23-0006 =VJrIRRIGATION PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
f City of Atlantic Beach PERMIT# l l R Z 00c
�, Building Department
800 Seminole Road Atlantic Beach,FL 32233
(P) 904-247-5800
SITE INFORMATION ` `
ADDRESS 5 \A.A\)1I C L ��v O. 1�\ PROJECT VALUE t 2 COO—
Contractor/Owner Irrigation Self Certification Checklist
Irrigation Standards: Please review all of the following standards prior to signing the certification section.
❑ High Volume irrigation, if used does not exceed 60%of landscape/pervious area
* Example:Total lot area=5,500 sq. ft.; Impervious area =2,200 sq.ft.;Total landscape/pervious area=5,500-2,200=
3,300 sq.ft.; Maximum High Volume Irrigation= 3,300 x 60%= 1,980 sq.ft.
❑ For lawns and turf areas that exceed 50%of the total landscape area of the lot, low volume irrigation may be used as
needed.
❑ At least one(1)moisture sensor shall be located in each irrigation zone.
❑ Emitters shall be sized and spaced to avoid excessive overspray on to impervious surfaces.
❑ A hydrozone plan must be submitted that indicate areas to be irrigated and shows low, moderate and high water use areas.
Plans may be prepared by property owners or contractors on a copy of the survey or a site plan.
❑ RPZ backflow preventer must be installed for all irrigation systems. Backflow preventers must be tested by a certified tester
and results sent to Public Utilities.
❑ Irrigation system shall be installed according to Section 24-178.
Permit becomes void if work does not commence within a six(6) month period or work is suspended or abandoned for six(6)
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 INFORMATION
OWNER NAME ��O \NJ\ PHONE# (6k0t4) 22\ ^ 000S-
COMPANY \-VCy_0,12 / CSE \ANyz:-S_rzy OFFICE# (6\o1-6 22t _ (Doc
COMPANY ADDRESS \ l t 5 ‘v•-/ L,Et.\A \a) FAX#
CITY J Cu--Co aV\U,E. STATE V ZIP CODE -7j222'-5 EMAIL h‘‘Cko -t,�CreL rm,1 --e- rl,�F S �I
LICENSE HOLDER-1—:(24.)"--) <$ M STATE CERT/REGISTRATION# J_ — 2-�✓' j `1
—gt) .1 mak . '1113
SIGNATLICENSE LDER PRINT OR TYPE NAME DATE
Signed and sworn before me on this day of FebrUa YLL by State of FLO f-I Df
p County of Di? 02FL--
Identification verified: -Persenai �OLCr- ))o rte e
Oath Sworn: [k Yes ❑ N n e c a._ € a�
' LORI A.MCELHANEY 'L� �J
Commission'HH 072049 otary Signature d
;; ���P:` Expires December 14,2024
«n::•`' BordedThu Troy Fain insurance 800-365-7019 My Commission expires 1 /i i Jo2'4
30 IRRIGATION PERMIT APPLICATION 11.10.2021 1
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5��-�,,; Plumbing Permit Application **ALL INFORMATION
2. \r HIGHLIGHTED IN
it
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
Cjlp, *11 n , ,r
JOB ADDRESS: 5`C U 1-'\\J� U\� 60 )• IA. PROJECT VALUE $ 7Q0 ,—
[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
DVIISCELLANEOUS
OS-wer Replacement
►it c ck Flow Preventer ‘;(.0
l Lawn Sprinkler System (number of sprinkler heads)
D3rease Interceptor (Trap) gallons (Requires 3 sets of plans)
0 Well **SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
DOther
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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: <9--0.7( Phone Number: (6t DLO Z21- Nods
Plumbing Company: \CI Q-`� (;QE. Y- Q -1 Office Phone:MU-4/ V O(�-j Fax N )
Co. Address: \2 )\`7 `,V I- NA RD• Cityif\L --S0 I\I Lk State:Ft Zip: 32-25-
License Holder: c2-0 "D\ State Certification/Registration # -- s
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Notarized Signature of License Holder SLA / .-r- 2,3q L L
The foregoing instrument was acknowledged before me thisQ8 day of f •bcuuL't.R, , 2002-3, in the State of Florida,
County of f)uVcU
r
t .; .• LORIA.MCELHANEY Signature of Notary Public�� A (9 , 11/6 ([. a' )U
tr
00 • Commission#HH 072049
�`a
;,,, ?e`� Expires December 14,2024 [ ersonally Known OR [ ] Produced Identification
:!os F`. •' Bonded Thu Troy Fain Insurance 800.3857019
Typ of Identification:
Updated 10/17/18