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Permit Remodel Bath 103 Fleet Land 2011 s 'I CITY OF ATLANTIC BEACH rr At 0 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002425 Date 8/03/11 Property Address 103 FLEET LANDING BLVD Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 2350 Application desc shower remodel Owner Contractor NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS RETIREMENT FOUNDATION, INC 1 FLEET LANDING BLVD 6771 SHINDLER DR ATLANTIC BEACH FL 322334599 JACKSONVILLE FL 32222 (904) 838 -9179 Permit PLUMBING PERMIT Additional desc . Sub Contractor . ASHLEY PLUMBING CO INC Permit Fee . . . 69.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 1/30/12 Other Fees STATE PLBG DCA SURCHARGE 2.00 STATE PLBG DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 69.00 69.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 73.00 73.00 .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: / (Q;-- 0^'-`.- c) 9 PERMIT # �/ v7� NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE OF FIXTURE QTY TYPE OF FIXTURE Bathtub QTY Clothes Washer Septic Tank & Pit Dishwasher Shower XL Drinking Fountain Shower Pan Floor Drain Slop Sink Floor Sink Three Compartment Sink Hose Bibs Toilet Kitchen Sink Urinal Laundry Tray Vacuum Breakers Lavatory Water Connected Appliances Other Fixtures Water Heater Water Treating System RE -PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE Bathtub QTY Clothes Washer Septic Tank & Pit Dishwasher Shower Drinking Fountain Shower Pan Slop Sink Floor Drain Floor Sink Three Compartment Sink Hose Bibs Toilet Kitchen Sink — Urinal Laundry Tray Vacuum Breakers Lavatory Water Connected Appliances Other Fixtures Water Heater Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans) ❑ Lawn Sprinkler System - Number of Heads ❑ Well ** ** SJRWD Well Completion Form. Com leted form to be submitted to the Building Department for final inspection. ** ❑ Other 606' 40 S i SP- 1) 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 % %CCI C4,,,- O f,, Phone Number Plumbing Company A, 4/e'7 A)-1/.) C Office Phone ` 1 -- 7 / r? Fax Co. Address: ( i- City -- ��° ;, - - � ' r ` r - � y � State � Zip ��Z�� ` ' : • ; : - _ 1 _� Notarized State Certification/Re istration # �i %� t�. , m soy, L L , der g o y 10'7' _ , , e6 �� / / /��► —�'� , Donded Notary Piti) ;: , iwnters v..,., Pws" "*" 4'4"'" . • and subscribed before m t 's 1 /l day of 24 Signature of Notary Public go YO r/ 79 S- 3 Y , ` \ CITY OF ATLANTIC BEACH ; 7 %' 800 SEMINOLE ROAD J�� ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 � 0 131> r ' Application Number 11- 00002425 Date 8/01/11 Property Address 103 FLEET LANDING BLVD Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 2350 Application desc shower remodel Owner Contractor NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS RETIREMENT FOUNDATION, INC 1 FLEET LANDING BLVD 6771 SHINDLER DR ATLANTIC BEACH FL 322334599 JACKSONVILLE FL 32222 (904) 838 -9179 Permit RESIDENTIAL ALT /OTHER Additional desc . Permit Fee . . . 65.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 2350 Expiration Date . 1/28/12 Other Fees STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 65.00 65.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 69.00 69.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: 1'03 NP - UAL ►ca.. Permit Number: Legal Description Parcel # Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ 23 Proposed Work heated /cooled non- heated /cooled Class of Work (circle one): New Additionteratioi Repair Move Demolition pool /spa window /door Use of existing /proposed structure(s) (circle one): Commercial ident i I If an existing structure, is a fire sprinkler system installed? (Circle one): Yes ICI, N /A Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed: - • -, ■ 1 , `. \AW'S ) otAS ; A -44D ,S/1Q Property Owner Information: Naive: M ca F Address: 'Ov.,e A r4 L-&r l= - \vc�.. City A ge, a.L . State ip T7iz 3 Phone E - Mail or Fax # (Optional) Contractor Information: Company Name: '00A. V ,vim A, 1 r,n3 5.,(1.A~1,c,,ti,$ Qualifying Agent: SoSk.1.44% .v� Address: (6Y1 \ Slh r�(eL- TJC City 'S '+ -scr\vi it(' State FL Zip 3z- z-z z.. Office Phone Job Site/ Contact Number $3'6 --9 l'1 Fax # 61 - j4 State Certification /Registration # t G C. 1 S ( S 9 l 8 Architect Name & Phone # -- Engineer's Name & Phone # Fee Simple Title Holder Name and Address ---- Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null at w ork void if of 1 commenced nderstand th t at separate permits must be for Electrical p Wo k, Plumbing, Signs, s, a Wells,PoolsXFurnaces, SBoilers, time Hea� Heaters. Tanks and Air Conditioners, etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF WITH YOUR LENDER OR COMMENCEMENT. I hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any oilier federal, state, or local law regulating construction or the performance of construction. Signature of Owner A s Signature of Contracto -+144 LA _. 1 A Print Name -- �.� 1 RC#[ .. Print Name al J Sworn to and subscribed before me Sworn to and subscribed before me this Day of , 20 this Day of aA �� . 20 1 1 a/ �.-' / ,./ _ ' _ o ary Pu;lic Notary Pub S ( ` 4 ;Z:' , ELIZABETH TESKE ti �,r r. 4 ,� ELIZABETH TESKE I = ip�' �% iN W NbI1 - �ItbOI Florida ' 0 ` 4's Notary Public - State of Florida I �1 I I; ;! My Comm. Expires Apr 5. 2013 l My Com m. Expires Apr S, 2013 Commission N DO 867829 _. Com mission DO B6702ti t ' ' u , . W '�� Bonded Through National Notary Man. I v 1 i — — : :_" •