710 TRITON RD - PERMIT PLRS18-0114 i-
,_____()
v\l‘f. ' � CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
,� vATLANTIC BEACH, FL 32233
" INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0114
Description: 6 FIXTURES
Estimated Value: 0
Issue Date: 4/27/2018
Expiration Date: 10/24/2018
PROPERTY ADDRESS:
Address: 710 TRITON RD
RE Number: 171339 0000
PROPERTY OWNER:
Name: COOK AUSTIN M
Address: 710 TRITON RD
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: B & G PLUMBING, HEATING & AIR CONDITIONI
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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* 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$7,500.
PLUMBING PERMIT APPLICATION n
_01 (
CITY OF ATLANTIC BEACH p(.�S�O�
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax(904)247-5845 Kest,
JOB ADDRESS: 1 10 TA I ro 04 toAD PERMIT# 18-- oo 1 o
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer I Shower I
Dishwasher _ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet I
Hose Bibs L__._ Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray _ Water Connected Appliances __- _.
Lavatory t " Water Heater t
Other Fixtures Water Treating System
RE-PIPE: l0
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:
n Sewer Replacement 0 Back Flow Preventer Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
o Lawn Sprinkler System-Number of Heads E Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
n 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 AJS'rtN Coo K Phone Number
Plumbing Company PS *6 I'lv PAA 4"1G C G Office Phone A.a3-3 S es Fax 123- 3 7 s c
Co. Address: 2.131 Co R PoRI YaS S q_ g Lv.o City 74c t(sowv,u,z State .Ft Zip 3 3.s 6
License Holder(Print): Cr6Ja C- R ovF�d? State Certification/Registration# C Fca z2 sq3
Notarized Signature of License Holder _.Q).C,•._CS PAA.-----
1
,��.1mo�, LORI S.NORDGREN
�►� ei, Irn and subscribed before this 21 4 day of Par 2 18
� P. `�i Notary Public-State of Flora/ o d
,. Ar
` �; Commission#FF 94733 A.
My Comm.Expires Mar 10. ftrtature of Notary Public
0 '"' O`"'�, Bonded through National Notary Assn.
s Cash Receipt Number ister Recei
t
City of Atlantic Beach R4915
DESCRIPTION ACCOUNT QTY I PAID
PermitTRAK $101.00
PLRS18-0114 Address: 710 TRITON RD APN: 171339 0000 $101.00
PLUMBING $97.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 6 $42.00
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: R4915 $101.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
04;27;2018 15:42:18
CREDIT CARD
VISA SALE
Card# XXXXXXXXXXXX8414
SEQ#: 9
Batch#: 594
INVOICE 9
Approval Code: 035318
Entry Method: Manual
Mode: Online
Tax Amount: $0.00
Card Code: M
SALE AMOUNT $101,00
CUSTOMER COPY
Date Paid: Friday,April 27, 2018
Paid By: B &G PLUMBING, HEATING &AIR
Cashier: BA
Pay Method: CREDIT CARD 9
/%
Printed: Friday,April 27,2018 3:43 PM 1 of 1 fit+
IINGT