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87 19th Street IRR23-0005 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP: CROSS ANDREW ET AL 1322 EASTWIND DR JACKSONVILLE BEACH FL 32250 COMPANY:ADDRESS:CITY:STATE:ZIP: Rick's Lawn Sprinklers, Inc.6806 Dayton Road Jacksonville, FL Jacksonville FL 32210 TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 169723 1025 NORTH ATLANTIC BEACH JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 87 19TH ST IRRIGATION IRRIGATION $2800.00 LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 1 PUBLIC UTILITIES UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL Notes: Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is needed, call 247-5878. Any digging requires calling 811 to have ALL public utilities located. 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: 4/26/2023 PERMIT NUMBER IRR23-0005 ISSUED: 4/26/2023 EXPIRES: 10/23/2023 IRRIGATION PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $65.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $32.50 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $101.50 2 PUBLIC UTILITIES RPZ BACKFLOW INFORMATIONAL Notes: A reduced pressure zone backflow preventer must be installed if irrigation will be provided or if there is a private well on the property. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities. TESTER FORM ATTACHED 2 of 2Issued Date: 4/26/2023 PERMIT NUMBER IRR23-0005 ISSUED: 4/26/2023 EXPIRES: 10/23/2023 IRRIGATION PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 s A4 , IRRIGATION PERMIT APPLICATION FORINTERNALOFFICEUSEONLY of City of Atlantic Beach PERMIT# ,Z3- == 0 Building Departmentc r on > 800 Seminole Road Atlantic Beach, FL 32233 P)904-247-5800 SITE INFORMATION j k L ADDRESS a '1 11 T PROJECT VALUE C .VD C . 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 CAA, I 0 <<Y 5 LA L- 15 4-77 P t PHONE# CIO II-z I q -0 3 I COMPANY OFFICE# COMPANY ADDRESS ‘gD6 OA yi+0 K FAX# CITY 7.1-0.-)( STATE I PL ZIP CODE 32210 EMAIL fLS rwLgl 7Oaf 6 ;1 ,LWp LICENSE HOLDER arl IQ 1 c-Yi ;(,t,,.t JS 11r0 STATE CERT/REGISTRATION# 7'-.5 S " J et-4- 12 ^ekk5L C _04'1 /{ r c k S u in d S T rv44-1 SIGNATUR OF LICENSE HOLDER PRINT OR TYPE NAME DATE I7Signedandswornbeforemeonthis Ir day of re-k- 21023byStateofr aCounty of D(Dv-c-- Identification verified: d_NAj3°b TONIGINDLESPERGER Oath Sworn: Yes ip ';, MY COMMISSION#GG 353178 j,•-.4oP' EXPIRES:October 6,2023 Bonded ThruNotary Public Underwriters Notary Signature My Commission expires 30 IRRIGATION PERMIT APPLICATION 11.10.2021 a rJa r d 41 SSbf, t .t '- f i / I i 1 i af4M MO ` 6 9-1'9 d i Ja i J1 (''1____: M-'-'?0 Old rad 9 1. 1 u g S,ap.) iy-,r-„ , ,,,tv City of Atlantic Beach—BACKFLOW PREVENTION ASSEMBLY TEST REPORT 902 Assisi Lane Jacksonville, Florida 32233 Phone: 904-247-5886 Name of Premises: _____________________________________________ Account No: ____________________________ Service Address: _______________________________________________________________________________________ Mailing Address (If Different): ____________________________________________________________________________ Contact Person: ________________________________________ Phone Number: __________________________________ Type of Service: Process Fire Domestic Irrigation Other: ________________ Type of Assembly: ___________________________________ Manufacturer: _____________________________________ Model: ____________________________________________ Serial No: _________________________________________ Size: ______________________________________________ Location: _________________________________________ Gauge Manuf: _________________________Serial No: ________________________ Date Calibrated/Verified: _____________ Remarks: ______________________________________________________________________________________ I certify that the data in this report is accurate. Tester Name (print) : _______________________________________ Date: ________________________________ Tester Signature: __________________________________________ Phone: _______________________________ Affiliation: ________________________________________________Cert No.: ______________________________ Tester Company: __________________________________________ Address:______________________________ THIS ASSEMBLY PASSED FAILED Email completed form to Ebrown@coab.us/jdsmith@coab.us Initial Repairs Final Check Valve #1 Check Valve #2 Relief Valve PVB or SVB Closed tight at __________ PSI Leaked Closed tight at ___________PSI Leaked Opened at __________PSI Did Not open Air inlet opened at _________ PSI Did not open Check Valve Held at _________PSI Leaked Cleaned only Replaced: Rubber Kit CV Assembly Disc O-Rings Seat Spring Stem/Guide Retainer Lock Nuts Other, Describe Cleaned Only Replaced: Rubber Kit CV Assembly Disc O-Rings Seat Spring Stem/Guide Retainer Lock Nuts Other, Describe Cleaned Only Replaced: Rubber Kit CV Assembly Disc O-Rings Seat Spring Stem/Guide Retainer Lock Nuts Other, Describe Cleaned Only Replaced: Rubber Kit CV Assembly Disc O-Rings Seat Spring Stem/Guide Retainer Lock Nuts Other, Describe Closed tight at ___________PSI Closed tight at ___________PSI Opened at _____PSI Air Inlet ______________PSI Check Valve _____________PSI City of Atlantic Beach—BACKFLOW PREVENTION ASSEMBLY TEST REPORT 902 Assisi Lane Jacksonville, Florida 32233 Phone: 904-247-5886 Name of Premises: _____________________________________________ Account No: ____________________________ Service Address: _______________________________________________________________________________________ Mailing Address (If Different): ____________________________________________________________________________ Contact Person: ________________________________________ Phone Number: __________________________________ Type of Service: Process Fire Domestic Irrigation Other: ________________ Type of Assembly: ___________________________________ Manufacturer: _____________________________________ Model: ____________________________________________ Serial No: _________________________________________ Size: ______________________________________________ Location: _________________________________________ Gauge Manuf: _________________________Serial No: ________________________ Date Calibrated/Verified: _____________ Remarks: ______________________________________________________________________________________ I certify that the data in this report is accurate. Tester Name (print) : _______________________________________ Date: ________________________________ Tester Signature: __________________________________________ Phone: _______________________________ Affiliation: ________________________________________________Cert No.: ______________________________ Tester Company: __________________________________________ Address:______________________________ THIS ASSEMBLY PASSED FAILED Email completed form to Ebrown@coab.us/jdsmith@coab.us Initial Repairs Final Check Valve #1 Check Valve #2 Relief Valve PVB or SVB Closed tight at __________ PSI Leaked Closed tight at ___________PSI Leaked Opened at __________PSI Did Not open Air inlet opened at _________ PSI Did not open Check Valve Held at _________PSI Leaked Cleaned only Replaced: Rubber Kit CV Assembly Disc O-Rings Seat Spring Stem/Guide Retainer Lock Nuts Other, Describe Cleaned Only Replaced: Rubber Kit CV Assembly Disc O-Rings Seat Spring Stem/Guide Retainer Lock Nuts Other, Describe Cleaned Only Replaced: Rubber Kit CV Assembly Disc O-Rings Seat Spring Stem/Guide Retainer Lock Nuts Other, Describe Cleaned Only Replaced: Rubber Kit CV Assembly Disc O-Rings Seat Spring Stem/Guide Retainer Lock Nuts Other, Describe Closed tight at ___________PSI Closed tight at ___________PSI Opened at _____PSI Air Inlet ______________PSI Check Valve _____________PSI