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1757 W Park Ter 14-00000319 plbg permit CITY OF ATLANTIC BEACH sJ 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 14-00000319 Date 3/13/14 Application Number 1757 W PARK TER Property Address . . Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . 0 ----------------------- -- -------------------------------------------------- Application desc REPLACE HOT WATER HEATER ------------------------------ Contractor Owner --------------- GODFREY BES5IE ROTO ROOTER SERVICES 1757 PARK TER W 2028 W 21ST ST LE FL 32203 ATLANTIC BEACH FL 322335611ACKSO354L7321 ----- -- - - Permit . , _ , PLUMBING PERMIT Additional desc . Plan Check Fee . 00 Permit Fee . . . . 62 . 00 0 Issue Date Valuation Expiration Date . . 9/09/14 2 . 00 Other Fees STATE PL BG DCA SURCHARGE STATE PLBG DBPR SURCHARGE 2 . 00 ------------------_-------------------------------------------------- Fee summary Charged Paid Credited Due ------------ ---------- ------- . 00 62 . 00 . 00 Permit Fee Total 62 . 00 00 00 . 00 Plan Check Total • 00 4 . 00 . 00 . 00 Other Fee Total 4 . 00 66 . 00 . 00 . 00 Grand Total 66 . 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: 7 I Aft.K 11,&2 i--.1 r^ g--i" PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value $ 9-5-0. 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 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 iESS 4 C> 1) FR E T Phone Number Qty 6" o q 6 C> Plumbing Company A# e &nfiZ2 .S'�fJjCfS Co Office Phone �5�1_�32� Fax �l-gaSS Co. Address: g O ari U!i A L'"t St�-C,;,+ City S+AC.�& kVE State F L Zip :5 22 0 License Holder (Print): D 36�'l Stat Certification/Registration# 02 FCb el K I L3 Notarized Signature of License Holder RACHEL MJDAWO Sworn and subscribed before me this 1 day of Ma1—tln. 20 14 NOTARY PUBLIC Signature of Notary Public STATE OF FLORIDA • Comm#EE844697 Ekpk"10/17/2016 03/07/2014 10:17 9043549255 ROTOROOTER PAGE 02102 PLUMBING PERMIT APPLICATION CJTY OF ATLANTIC 13EACH 800 Semi>iole Rd Atlantic Beach, FL 32233 Ph (904) 247-5826 1~a7,( (904) 247-5845 JOB ,ADDRESS. rz., PE>( MIT# ems cp ��` NEW OR REPLACEMENT INSTALLATION: Project Value S^ 8— TYPE OF FIXTURE QTY TYPE OF.SIX rURE Q rI Bathtub Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain ,,_,,, Three Compartrr►ent Sink Toilet Floor Sink Urinal ---�— Hose Bibs Vacuum Breakers - Kitchen Sink -- Water Connected Appliances — Laundry Tray --- Water heater Lavatory Water-- Water Treating System other Fixtures Fixtures TYPE OF, k`wURE QTY TYPC, Or-FIXTURE QrY Bathtub Septic Tank& Pit Clothes Washer Shower -- Dishwasher Shower Pan - Drinking Fountain _ Slop Sink Floor Drain Three Compartment Sink Floor Sink _ Toilet: Mose Bibs _ Urinal Kitchen Sink _ Vactnarn Breakers — Laundry Tray Water Connected Appliances Water Reater --� Lavatory --- Water Treating System — Other Fixtures MISCELLANEOUS: gallons Rc vires 3 sets of Plans) o Sewer Replacement o Back Flow Preventer J Grease Interceptor (Trap) I= (Requires, ❑ Lawn Sprinkler System-Number of Heads C7 Well ** — be submitted to tYte T3uildia�g Department for final inspection.** SJRTTID Well COmpletion corm. Completed foam to O Other y that or 2717 if Permit becomes void if work does not cemi eeand correct SII p ovis oin a six month ns of laws and or(t iod or W1 r ncesdeclgovern,6 this or aban6o work w 11 behcomplicd witlMwhcthetIspeccfic la chis application ane{know the same to h or not. The permit does not give authority to violate : c provisions of any other Srate or local law regulation construction or the performance of construction. Phone Number ay �- 6 a-Property Owners Name umbiz�g Company D ° ` Office Phone 3Sq-7,3,1,% Fax Pl p Co. Address: . y _ 6.4 City +AC�C_�vn�tA�� State F-L 7i1) 2-'Z License Holder(Print): �D � Stat Certiil1c atiorl Rcgistration CFC O 41!y13 1 Notarize!Signature of License 1-folder Swa and subscribed beforeme this day of M t1 t Gln' 20 1 H RACHEL DUDI1SKOi WTARY PUBLIC Sig, ure of Notary Public NOVA, —-- ---- 03/07/2014 10:17 9043549255 ROTOROOTER PAGE 01102 Roto-Rooter Services COMPSMY 2028 West 21 at MOO AOft� OTER, (904)3 0-9 11 3220�a (904)350-9111 PLUMBING & DRAIN SERVICE pAX COVFR SHEET ., Lt Date: - � Company: LA�k `� c,�-nc,� Fax No. From: 'FAA 1z- - Phone: 904 354-7321 Ex. 11-\ e1j Pax No. 904 354-9255 Pages (including cover sheet): 3 rS��rJ� 7 Cash Register Receipt Receipt Number „r City of Beach • ' • • DESCRIPTION • CITY PAID PermitTRAK $66.00 14-00000319 Address: 1757 W PARK TER APN: 172020 0378 $66.00 BUILDING $66.00 BUILDING PERMIT RENEWAL 455-0000-322-1000 0 $66.00 •TAL FEES PAID BY RECEIPT: R10828 $66.00 Date Paid: Thursday, October 24, 2019 Paid By: ROTO ROOTER SERVICES Cashier: CT Pay Method: CREDIT CARD 049841 Printed:Thursday, October 24, 2019 10:29 AM 1 of 1 14