Permit Plbg Replace Sewer 125 Donner 2011 `f y CITY OF ATLANTIC BEACH
� `'° j 800 SEMINOLE ROAD
' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
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Application Number 11- 00002371 Date 7/21/11
Property Address 125 DONNER RD
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
REPLACE SEWER LINE
Owner Contractor
DOVE, SR., JAFORD STYLES SMITH PLUMBING, INC
125 DONNER ROAD 1537 PENMAN ROAD SUITE A
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 241 -4131
Permit PLUMBING PERMIT
Additional desc . REPLACE SEWER LINE
Permit Fee . . . 62.00 Plan Check Fee .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 1/17/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 62.00 62.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 66.00 66.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph 904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: 1 2 //-- I � �� (� PERMIT # Z 37/
NEW OR REPLACEMENT INSTALLATION: Project Value $
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
4
RE -PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY " L
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink g'11.
Floor Sink Toilet j 0 71
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers ;r
Laundry Tray Water Connected Appliances /
Lavatory Water Heater /
Other Fixtures Water Treating System
SCELLANEOUS:
wer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
Lawn Sprinkler System - Number of Heads El Well **
* SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other At� / ; ._ ' ✓
/ 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.
Property Owners Name Phone Number
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Plumbing Company 54 1 1 �s , '\ \ `` `� V 'M ,� Office Phone Fax
Co. Address: ) 53 —� 'rpy a\ A (\ V r Cityy ► 1 1 1 State Zip
License Holder (Print): 11 it - 41.-a., A, Stat Certification/Registration # CF(O y �
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Notarized Signature of License Holder - '. - -- .. - .41111
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,,, , p®o AMM4�AWH�E worn and subscribed before e th' , i ; dart* fiff% 20 /7
v : MY COMMISSION # EE 057349 ,r
1* � � EXPIRES. may u 1, a Signature of Notary Public L f .
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CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET
Address l X15 ) A l t.1
Dates
Heated Square Footage % L /kY @ $ 2/,00 per so ft = s 6 '7 Z-
Garage /Shed is/r62) @ S g(.0 . er ft _
o p sq :.� - S /i � �CC7
Carpor : /Ford- '' @ S / 0 . C C per sc _ t - S /. 0 /
Dec 0 (a S 6 per so ft - S G
Pat / G / 4 @ S L /:0 0 per s rt = c
TOTAL VALUATION: ; �1 /5 2--
i., OI'� .
l (S —z— 26 G,0 c, „ 1 0.0
icta: Valuation 1st ;$ O Erb 0
7 /.3 z ' f Z &
s f Zo , C;0
Rernaln"llg Value $ caper thousand
o f portion thereof
TOTAL BUILDING FEE S :5 c-c). 0 o
T 2./2 Filing Fee $ / `7 6 0 0
( ) Fireplaces @ $15.00 $
BUILDING PERMIT FEE S C cn _ e 1
WATER IMPACT FEE $ 1 -7'3 ( . 9 . 0 c
SEWER IMPACT FEE S i ..7-.ro .o
WATER METER /TAP S k j O b
6\9 CAPITAL IMPROVEMENT S ? 2r 0 e)
U SEWER TAP 5 ,_
\ ii\
'lYaSI' RADON (HES) .0050 r `2.C)-7. ;� 7--
SECTION H PAVING ( S ^L ) $ '-.4 o
HYDRAULIC SHARES S e
/f CROSS CONNECTION $ '.S"
S
(� (P r * SURCHARGE .0050 "6 /, '�
OTHER $ .
GRAND TOTAL DUE 5 3 (j '4i,69'eY
'.!' \J - J- 4 4
J ' {
s =l CITY OF ATLANTIC BEACH
�" `' PUBLIC UTILITIES
1200 Sandpiper Lane
''':-/' p J S ) ATLANTIC BEACH, FL 32233
(904) 270 -2535 or (904) 247 -5874
NEW WATER/SEWER TAP REQUEST
Date: 7,0 /// Project Address: 4? S - A 4 4er /21
No. of Units: ( Commercial Residential ✓ Multi- Family
New Water Tap(s) & Meter(s) Meter Size(s)
New Irrigation Meter Upgrade Existing Meter from to (size)
New Connection to City Sewer 1/
Name: 174- s
Applicant Address: 14V —
City: State: Zip:
Phone Number: Cell Number: CI-1/
Email Address Fax:
Signature:'' a te - ' elec.
(Applicant)
CITY STAFF USE ONLY
Application#
Water System Development Charge $
Sewer System Development Charge $
Water Meter Only $
Water Meter Tap $
Sewer Tap $
Cross Connection $
Other $
TOTAL $
(notes)
APPROVED:
(Utility Director or Authorized Signature)
ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES
CAN BE ASSESSED
White, Debbie
From: Walker, Chris
Sent: Thursday, July 21, 2011 7:29 AM
To: White, Debbie
Subject: RE: SEPTIC TO SEWER 125 DONNER ROAD
We dug up the service yesterday and they are on city sewer. The reason they thought the service was bad was
there was a cable thru the service causing it to back up. because
From: White, Debbie
Sent: Wednesday, July 20, 2011 9:21 AM
To: Kaluzniak, Donna; Walker, Chris
Cc: Graham Shirley; Thompson, David; Ramsay, Debra
Subject: SEPTIC TO SEWER 125 DONNER ROAD
Styles Smith Plumbing has applied for a plumbing permit to replace a sewer line. When Mr. Smith went to the site and
met with Public Utility employees it was found that the sewer had never been connected. I have no record over here of
the fees being paid, however, they have been paying sewer fees and it appears
Jacksonville address and there was 0 consumption last month? The owner would like to finance this if bill possible. to
p
Can you let me know the following:
1. Were the fees paid to connect to the sewer? And amount due.
2. Can this be financed?
Donna K, I will send the new form over in interoffice mail.. Thanks, Debbie W
Debbie White
CITY OF ATLANTIC BEACH
BUILDING DEPARTMENT
(904) 247 -5826
(904) 247 -5845 FAX
1