621 Aquatic Dr 2013 bath remodel CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002226 Date 2/26/13
Property Address . . . . . . 621 AQUATIC DR
Application type description RESIDENTIAL ALTERATION
Property zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 150
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Application desc
bath remodel tile board
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Owner Contractor
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QUIONEZ DEBORAH A SIGNATURE HOMES & DEVELOPMENT
621 AQUATIC DR 731 DUVAL STATION RD
ATLANTIC BEACH FL 32233 STE 107-417
JACKSONVILLE FL 32218
(904) 759-9867
--- Structure Information 000 000 BATHROOM
Occupancy Type . . . . . . RESIDENTIAL
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Permit RESIDENTIAL ALT/OTHER
Additional desc . -
Permit Fee . . . . 55 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 150
Expiration Date . . 8/25/13
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total S5 . 00 S5 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 8 . 00 8 . 00 . 00 . 00
Grand Total 63 . 00 63 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002226 Date 2/26/13
Property Address . . . . . . 621 AQUATIC DR
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 150
----------------------------------------------------------------------------
Application desc
bath remodel tile board
----------------------------------------------------------------------------
Owner Contractor
------------------------
------------------------
QUIONEZ DEBORAH A SIGNATURE HOMES & DEVELOPMENT
621 AQUATIC DR 731 DUVAL STATION RD
ATLANTIC BEACH FL 32233 STE 107-417
JACKSONVILLE FL 32218
(904) 759-9867
--- Structure Information 000 000 BATHROOM
Occupancy Type . . . . . . RESIDENTIAL
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Sub Contractor . . CUSTOM PLUMBING AND TILE
Permit Fee . . . . 76 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/25/13
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 76 . 00 76 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 8 . 00 8 . 00 . 00 . 00
Grand Total 84 . 00 84 . 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 OFATLANTic BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTUP-E 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:
[-i Sewer Replacement El Back Flow Preventer o Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Ei Lawn Sprinkler System-Number of Heads o Well
** SJR WD Well Completion Form- Complete&—fonn to be submitted to the Building Department for final inspection.
C1 Other /;U 411,` 41,-.,ezl -e-,-- 4-1 '2"
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 1 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
33
Office Phone(k��Q- �L51 Fax�k'L��(-_-3'
Plumbing Company ,,- W&7''0 :�:�,�4�, V-7-/,/, .
- 0/ f city State Q Zip 3 a22
Co. Address: c27V'�t c5e 177�5A 'DR IV
License Holder(Print): ot.c State Certification/Registration 4 Q< 27-3S-
Notarized Signature of License Holder
r
Before me this �2&-, day of 1 20
MEUSSA A.W -7 _Z3
MYCOMMISSME861W5 4
Signature of Notary Public
EXPIRES:January 1,2017
Bonded Thru Notary Pulk Undwmftam
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: hic-_ -Permit Number:
Legal Description Floor Area of Sq.Ft. Parcel 9 Sq.Ft
Valuation of Work$ 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 Residential
If an existing structure,is a fire sprinkler system installed? (Circle.one): Yes No N/A
Florida Product Approval# _____Ff
For multiple products use product approva orm
Describe in detail the type of work to be performed:
Property Owner Information:
Name: Address:
city State—Zip Phone
E-Mail or Fax 9(Optional)—
Contractor Information:
CompanyName: �Aov-cy,* V, Qualifyigg Agent:
Address: '73 1 t_ . I o7 -#-t-7 Citv J State Zip 315-19
oo V a I S jtc
Office Phone —Job Site/Contact Number -7�) 9-990 Fax
State Certification/Registration# P_6C04-165'� �
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
ica e e ade ana er d he nd n a ns a 'ndicat rtify that no work or installation has commencedprior to the
i m to work a t t 1 s a" t 0 s s'I Irs
A ' 7' li it 0 0 t d to m he tan aid al ction in thisjurisdiction. Thispermit becomes null
io s' ym k be e e r
ork su nedfor a period of six P6)months at any time after
p v r to o't f rm hs, or Z "t s ,t or od
p c t and tha r
e o ape t
(6 n n
p
i's' all w hPii s f
a 'or mi t 0 .w
and id k s ot com enced t 'o t
", is, ."i ' n m 0 it t Obe secured or E c'J'a signs, Wells,Pools, A urnaces,Boilers,Heaters,
k ced. I, derstnd that separate Perm s m,
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 FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
Ihere certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordin ces governing this
t does not presume-to give authority to olate or cancel the
a
0
nd
r
or
din ces go
1�work will be complied with whether s ecified herein or not. The granting of a permi viestoto"goLl"austh ly to olate oi
provisions of any otherfederal,state, or local raw regulating construction or the pe�formance of construction.
Signature of Owner Signature of Contractor,,
.........
. ..... ........
Print Name Print Name . .................. .... .......... .................
.................
......... .................. .... .......
.......................................................................................................................................
Before me re 20
this Day of . 20 is
koly COMW31
E
u 11cLjn6er,%,q:r,,-,.
Notary Public
Revised 10.24.12