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Permit Bath Remodel 4107 Fleet Land 2011 t } 31.1 J' ,c 6 ' CITY OF ATLANTIC BEACH ;. ,� a $� I 1 I " 800 SEMINOLE ROAD "41 ATLANTIC BEACH, FL 32233 �� INSPECTION PHONE LINE 247 -5814 3 Application Number 11- 00002474 Date 8/10/11 Property Address 4107 FLEET LANDING BLVD Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 1400 Application desc SHOWER CONVERSION 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 . 60.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 1400 Expiration Date . 2/06/12 Other Fees STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 60.00 60.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 64.00 64.00 .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: 4) 01 fl eel L1 v�. Permit Number: Legal Description Parcel # Floor Area of Sq.r't. Sq.Ft Valuation of Work $ 1'100 Proposed Work heated /cooled non - heated/cooled Class of Work (circle one): New Addition Repair Move Demolition pool/spa window /door Use of existing /proposed structures) (circle one): Commercial 4' e ' • en. . If an existing structure, is a fire sprinkler system installed? (Circle one): '7: o N /A Florida Product Approval # For multiple products use product approval or - Describe in detail the type of work to be performed: Sk Con■Q Q■r - ?lx^ ■t-- Pan el ►A46,. ra cfc� .ki le Property Owner Information: Name: t kc- i Address: 0,46' 064-r L.AdoinK /3&41 City /a -(u}„ tslc- & Ac4 State r. Zip 3-z69 Phone tyre - WOO E -Mail or Fax # (Optional) Contractor Information: ii Company Name: ?o 'A 9 N , .► B c 1a r a c olteh r� Qualifying Agent: _ J tA1 +1CQ rr kddress: Col/ S i „a 1 ec City " jA 4--9:24..\./111( State Ft Zip 3Z2 ZZ office Phone Job Site/ Contact Number `,33R - 1/ Fax # State Certification/Registration # (C9-C 15 189/ 8 architect Name & Phone # Engineer's Name & Phone # ee Simple Title Holder Name and Address 3onding Company Name and Address Mortgage Lender Name and Address .� 1pplication 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 ssuance 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 and void f work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after vork is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, ranks 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. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. hereby certify that I have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this ype of work will be complied with whether speci ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the ■rovisions of any other federal, state, or local law regulating construction or the performance of construction. signature of Owner Signature of Contractor O 'riot Name fnA 1'H Print Name t o to ;worn to and subscribed before mp Sworn to and subscribed before m his 0l. Day of //- , 20 1i this /0 Day of /4- - S .ca s , 20 I 1 # �3a _ 4000.e.:/ . - - - dotary Pub 4 ,, , ELIZABETH Notary Pu c " u•`Si � p • ELIZABETH TESKE T T Notary Public -State of Florida lor � �.'? , My Comm. Expires Apr 5, 2 013 '� �� dt t Pjb0 - State of Florida Commission # 00 867829 i• i �, My Comm. Expires Apr 5, � 2013 v % °F �' Bonded Through National Notary Assn. Commission # 00 867 + f mis " ` Bonded TI. 829 rr `% CITY OF ATLANTIC BEACH r s-.), 800 SEMINOLE ROAD - ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002474 Date 8/23/11 Property Address 4107 FLEET LANDING BLVD Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 1400 Application desc SHOWER CONVERSION 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 . . . 62.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 2/19/12 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: `4 0 e 'a5t ( (J(J2 PERMIT # - 2"5‘77 j i 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 RE -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 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. Completed form to be submitted to the Building Department for final inspection. ** ❑ Other 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 F(e e ur Du h ` Phone Number Plumbing Company Ave-7 ��., --301, c a ...) `- Office Phone Fax Co. Address: City 13 q c State F/ Zip 2z--2--(5) License Holder (Print): , 4 / ■ •`V Sta : Certification/Registration # (& 0Y Notarized S t o License Holder `'��% , '' �i DEBORAH AMANDA W ��, ' t Al MY COMMISSION # EE om t o and subscribed befo = e is day of 20 �� EXPIRES: May 21 2015 ! / ;fy, Bonded Thru Notary Public 21, 2015 of Notary Pub -(� A