Permit Remodel Bath 3116 Fleet Landing 2012 0 � CITY OF ATLANTIC NTIC BEACH
A ) 800 SEMINOLE ROAD
J � ,,,Z ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000137 Date 2/01/12
Property Address 3116 FLEET LANDING BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 2075
Application desc
shower /bath remodel
Owner Contractor
NORTH RIVER BUILDING SOLUTIONS
6771 SHINDLER DR
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 . . 7/30/12
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 A 800 Seminole Rd Atlantic Beach, FL 32233 '1 3
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: S ( Co Fck 1,,,,,,-k).1,,,, 11 LO—
PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 1 Septic Tank & Pit
Clothes Washer Shower 1
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 **
** SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
Other x1-ve-, f / S/4 7 —S
Cote t' 7 / 7' 7 S 4 ,
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 7 )' f 7 - ,,,-V ,-' Phone Number
Plumbing Company J _5L7 dc 7 f%,- Li j ,.. C. = (-, Office Phone Fax
Co. Address: // le-t /'t.,/ ,� City J State if Zip 3 2 Z /,
License Holder (Print): �4y /, Ac.(, tate Certification/Registration # (',c 7f0`f
Notarized Signature of License Holder
Sworn and subscribed bef r(m I / /
da of Fa 20 /L-
in
Signature of Notary Public L /
(lir ' ' • � _ CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
, , ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
E c';
Application Number 12- 00000137 Date 2/01/12
Property Address 3116 FLEET LANDING BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 2075
Application desc
shower /bath remodel
Owner Contractor
NORTH RIVER BUILDING SOLUTIONS
6771 SHINDLER DR
JACKSONVILLE FL 32222
(904) 838 -9179
Permit RESIDENTIAL ALT /OTHER
Additional desc .
Permit Fee . . . 65.00 Plan Check Fee .00
Issue Date Valuation 2075
Expiration Date . . 7/30/12
Other Fees STATE DCA SURCHARGE 2.00
STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR 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 8.00 8.00 .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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: / . , , * ' Permit Number:
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ «0 75 Proposed Work heated /cooled non- heated /cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool /spa window /door
Use of existing /proposed structure(s) (circle one): Commercial Residentia
If an existing structure, is a fire sprinkler system installed? (Circle one . ;,, 10 N /A
Florida Product Approval #
For multiple products use product approva or' rm
Describe in detail the type of work to be performed: (3. bo4 sko4.sc- .re,v t.� aN
Aid ,pakSS A... e oc,n - b Pc , .rzrt v.1tali C r-� e.v�
Property Owner Information:
Name: NCCRF Address: One Fleet Landing Blvd.
City Atlantic Beach State FL Zip 32233 Phone 904 - 246 -9900 xt.150
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: North River Builders Qualifying Agent: Joshua M. Hogan
Address: 6771 Spindler Drive City Jacksonville State FL Zip 32222
Office Phone 904 - 838 -9179 Job Site/ Contact Number 904 - 838 -9179 Fax # 904 - 838 -9179
State Certification/Registration # CGC 1518918
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
and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for aperiod of six (6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, 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. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
1 hereby certify that 1 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 other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner "- -1 \I'
4 Signature of Contractor�� ∎,.. ;.;
0 Print Name Joshua Hatfield Print Name Joshua M. Hogan
Sworn to and subscribed Wore me Sworn to and subscribed be ore me
this / ! Day of re- 20 / 2 this L Day of before
20 /t
Air
3, ki / / Ape
-'-'' I ABETH TESKE I / r'ri
of Public io` "�` °'' ;'s Notary Public - State of Florida i ot, Public ;r° ' " Notary Public - State of Florida
i• My Comm. Expires Apr 5, 2013 ` �'- • �• My Comm. Expires Apr 5, 2013
; , Commission # DD 867829 �'"••� ".: � Con is e#i 8a682J
' °F c. • ', - J
Bonded Through National Notary Assn. ` ;f os r� ,,r`�
,,,, ,,,, Bonded Through National Notary Assn.