314 12th Street IRR23-0022 App , 01--''' . IRRIGATION PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
'9f City of Atlantic Beach PERMIT# .,-P--C-2 -CC22-
F,) Building Department
800 Seminole Road Atlantic Beach, FL 32233
—on
(P)904-247-5800
SITE INFORMATION � C
ADDRESS 3\1' l Z- JT PROJECT VALUE 4 2 5oc
Contractor/Owner Irrigation Self Certification Checklist
Irrigation Standards: Please review all of the following standards prior to signing the certification section.
E 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)
Imonths. 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 V-0\ �51 ►\"n l PHONE# (go) 231 • c (Z3
COMPANY \LY.-D Y C��Z._\L i,\,\3Q..5.N2.y OFFICE# ( b4 771 ' Plc OS
COMPANY ADDRESS i 2J. 1 t= \\) L. ..----‘•.1 f\ ' ) . FAX# 1N1 ( P1
CITY JV\CE--S043vk1, Lt STATE\ L ZIP CODE 37-22.5 EMAIL W(.1Cpric ceekr1u`CSe('\
LICENSE HOLDER -1—\24.0V �\1' \ STATE CERT/REGISTRATION# t`n0.i co
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SIGNATURE OF LI NSE HOLDER PRINT R TYPE] NAME DATE
Signed and sworn before me on this )61 ft day of ills "Y1be9'- r Q2 by State of Flo r )(LCt
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I Y( I , 1-) S1 In County of Atv-o.
Idertil+Eatier+verified: r- a"1Cc L Iii .i1[fit i fl 11e
Oath Sworn: L`J Yes ❑ No
; .....' LORI A.MCELHANEY ,�e (Z _
"I Commission HH 072049 - _,,,L__•: ;' '�: otary Signature /
���r,:= Expires December 14,2024
F�t,f�0' Bonded TMu Troy Fain Insurance 800-305101! // I/,-)
y Commission expires of
30 IRRIGATION PERMIT APPLICATION 11.10.2021
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