761 Paradise Ln plbg permit . i '
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
v,t INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0015
Description: install 22 fixtures
Estimated Value: 0
Issue Date: 1/12/2018
Expiration Date: 7/11/2018
PROPERTY ADDRESS:
Address: 761 PARADISE LN
RE Number: 172376 0185
PROPERTY OWNER:
Name: SPRINGFIELD BUILDERS LLC
Address: 1881 BEACH AVE
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: B & G PLUMBING CO., INC.
Address: 2232 CORPORATE SQUARE BLVD 2232 CORPORATE
SQUARE BLVD
JACKSONVILLE, FL 32216
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
TOB ADDRESS: �-� I �a Yq d I S e L A h e- PERmrr#
,IEW OR REPLACEMENT INSTALLATION: Project Value$ -
TYPE OF FIXTURE OTY TYPE OF FixTuRE OTY
Bathtub Septic:Tank&Pit
Clothes Washer Show,-r —1—_
Dishwasher Show-,r Pan —
Drinking Fountain _ SIop Sink
Floor Drain — Three Compartment Sink _
Floor Sink — Toilet
Hose Bibs — Urinal —'
Kitchen Sink — Z. Vacuum Breakers
Laundry Tray Water Connected Appliances I
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE OTY TYPE'OF FIXTURE OTY
Bathtub Septi;Tank&Pit
Clothes Washer Shower
Dishwasher ShovNer Pan _
Drinking Fountain Slop Sink
Floor Drain Three,Compartment Sink
Floor Sink Toilet
Hose Bibs UrinEi
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 ❑ VTell
**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 suspenlied or abandoned for six months.I hereby certify that I have rea
this application and know the same to be true and correct. All provisions of laws and ordirances 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 lo(al law regulation construction or the performance of construction.
Property Owners Name S Py i n q-Fi e)d u t 1d eS LLL Phone Number 40'+^l02b-b24S
Plumbing Company %A(Rr J u V% b;hq 1 t0• _Office Phoneg04-213-3585_Fax 901-394' Za
Co. Address:
2-,&.32- L01/P0''Q i- 6J;4Aye 01V4 City Taorko hyl I)C State�Zip_3-2-11L
License Molder (Print): "e State Certification/Registration 4 C FC 0 22551.3
Votarizerl SianaEure o Zic, rTzse oder
11
LORI S.NOROGREN wont and subscribed before mc: s ' d of y�Q h1 U Q 20
Notary Public-State of Florida
Commission#FF 847336 i afore of Notary Public
i� M Comm.Expires Mar 10,2020 >'�
Bonded through Naibnal Notary Assn.
r
l
Cash Register Receipt Receipt Number
City ofAtlanticBeach
DESCRI PTION ACCOUNTCITY PAID
PermitTRAK $214.23
PLRS18-0015 Address: 761 PARADISE LN APN: 172376 0185 $214.23
PLUMBING $209.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 22 $154.00
STATE SURCHARGES $5.23
STATE DBPR SURCHARGE 455-0000-208-0600 0 $3.14
STATE DCA SURCHARGE 45500002080700 0 $2.09
TOTALPAID BY
Date Paid: Friday, January 12, 2018
Paid By: B & G PLUMBING CO., INC.
Cashier: LE
Pay Method: CREDIT CARD 714
Printed: Friday,January 12, 2018 10:05 AM 1 of 1
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