425 Atlantic Blvd PLRS18-0173 repipe permit S"Ali-
' sf CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0173
Description: 24 FIXTURES
Estimated Value: 5000
Issue Date: 7/27/2018
Expiration Date: 1/23/2019
PROPERTY ADDRESS:
Address: 425 ATLANTIC BLVD
RE Number: 170696 0000
PROPERTY OWNER:
Name: MCGUIRE NANCY
Address: 425 ATLANTIC BLVD
ATLANTIC BEACH, FL 32233-4021
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: F.W. FAIR PLUMBING CO.
Address: P O DRAWER 51558 P.O. DRAWER 51558
JACKSONVILLE BEACH, FL 32250
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
v �1 800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 PL r'�
6
JOB ADDRESS: —1 �-� AT - 1—��C�L.,�/� PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ 5000
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 hower Pan
Drinking Fountain lop Sink
Floor Drain hree Compartment Sink
Floor Sink Toilet
Hose Bibs / Urinal
Kitchen Sink 1 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
** VRWD 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 o viol a the provisions of any o h r state or local law regulation construction or the performance of construction.
Property Owners NameL �' G " /�� Phone Number q Z-S-36
Plumbing Company �(A ) )-:�A I ik P( ✓yl Office Phone;? //- 71 q1 Fax,2W- )- 7-�-3
Co. Address: d• -Zkx S-/ f fy CitylAk MA C JH Stat"`• Zip�L L 7 b
License Holder (Print): ?5A J R State Certification/Registratiojo- 3 7 Sb3
Notarized Signature of License Holder
, Sworn and subscrib d before a this �d �dayf f /� 20�
t°;•••.�% MARVIN VERNON DUPREE
k * MY COMMISSION#FF 147645 Signature of Notary Public
V
EXPIRES:August4,2016
''rF,7d,P Bated Thru Budget Notary Services
TS
s
Cash Register Receipt Receipt Number
City of Atlantic Beach • •
DESCRIPTION • QTY PAID
PermitTRAK $228.58
PLRS18-0173 Address: 425 ATLANTIC BLVD APN: 170696 0000 $228.58
PLUMBING $223.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 24 $168.00
STATE SURCHARGES $5.58
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.35
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.23
• .
Date Paid: Friday,July 27, 2018
Paid By: F.W. FAIR PLUMBING CO.
Cashier:JJ
Pay Method: CREDIT CARD 00059G
Printed: Friday,July 27,2018 11:09 AM 1 of 1 j
TRWGT