388 SEMINOLE RD - PLUMBING L.,....,..,„
.t3 ' j'r , CITY OF ATLANTIC BEACH
._
iF ' 800 SEMINOLE ROAD
T41
xATLANTIC BEACH, FL 32233
'` osii> INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0059
Description: 2 FIXTURES
Estimated Value: 0
Issue Date: 7/21/2017
Expiration Date: 1/17/2018
PROPERTY ADDRESS:
Address: 388 SEMINOLE RD
RE Number: 170424 0000
PROPERTY OWNER:
Name: BELL FLOYD M
Address: 388 SEMINOLE RD
ATLANTIC BEACH, FL 32233-4145
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name:
Address:
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
07/20/2017 13:33 FAX 9016159363 atlantic-coast 001
05-06-16i10; 34 ;�ro� , To:96459363 ;9342u758':5 T 1/ 'I
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 I`�
Ph(904) 247-5826 Fax (904) 247-5845 V(, psi -7- 00519
JOB ADDRESS: S c7 ,11, ' ,,,,A+ . 4..0 ,, /� P.CRmir 1l#
NEW O REPLACEMENT INSTALLATION: Project Value$
TYPE.oFFLXTV1/e Orr rn.EOFFIXTURE QTY
Bathtub _ Soptic Tank$c Pit
Clothes WasherShower
Dishwastzer Shower Pan
Drinking Fountain Slop Sink
Floor T)rain Three Compartment Sink
Floor Sink Toilet " i
1-Io$FC Bibs --- 'Urinal
Kitchen Sink '" Vacuum Breakers
LavatorymsTray Water Conneoted Appliances
Fixtures j
Water RenterWatcl Creating System
tE-PXPE:
TYPE OPFarrow QTY 14l'L'OF FI.XT U1 E QTY
Bathtub Septic Tank&Pit
Clotho Washer -,__-_�.. Shower
Dishwasher ._.�_ Shower Pan
Drinking Fountain "" Slop Sink"
Floor ink Floor Drain Three Compartment Sink "`
Hose Bibs tlrrmToiler
Kitchen Sink Urinal
Kitchen Tray — .--_ Vnouum Breakers
Laundry
Water Conneoted Appliances
Other F
Lavatory
_—... Water Heater m__, .___
Water Treating System
[rSC.CLL.ANEOILTS:
Sewer Replacement o Back Flow A reventnr C Grease Interceptor(Trap)
Lawn Sprinkler System-Number of heads gallons(Requiressots of pious)
SJRWD Well Completion Porn!, Completed form to be submitted toth—elliftliaig Department for final inspection,*'
Dther
nit becwners void it work docs not corn eneo within a six mon Crulod or work is suapcnded or abandoned far alx months.I hKoby certify that I have read
application toed know the 9tunc to be true end correct All provision,of laws and ordinances governing this work will he complied with whether specified
Di. Tho permit does not give authority to violate the provisions of any otter stat or local law regulation construction or the performance of Oonstructi0n,
party Owners Name /ki. , d if/ii ,(_/ Phone Number o l 51014
robing Company bid #i il_ do r,,
0, 47 o _ Office Phone 9 J i-5:Z75 Fax .4",_ 7__L, ...5". 1,
Address: /, e • , i A r City , _ State Zip 2r , a
;joersc LToIder(Prilat): / ' P . • us.. �*), ,_ - : lflca il/Registration# CA'-eo.S0
arized Si, nai'ure of License Holder
,,.* LINDSAY BELMONT Before me this ,ge day of Lam/ N
Y�� Y COMMISSION�YFF949802 0 .
01
FXPIRES:JAN 12,2020 Signature of Notary Public . J�,4.,Ai . '
Bonded through 1st State insurance qi
,„t Cash Register Receipt Receipt Number
City of Atlantic Beach R2064
\Oii)>•,'
DESCRIPTION I ACCOUNT QTY I PAID
PermitTRAK $73.00
PLRS17-0059 Address: 388 SEMINOLE RD APN: 170424 0000 $73.00
PLUMBING $69.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 2 $14.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R2064 $73.00
Date Paid:Thursday, July 20, 2017
Paid By: BELL FLOYD M
Cashier: CT
Pay Method: CREDIT CARD 042815
Printed:Thursday,July 20,2017 3:28 PM 1 of 1 i
TWIT