286 POINSETTIA ST - PLUMB Cf CITY OF ATLANTIC BEACH
.; r ' 800 SEMINOLE ROAD
_ ATLANTIC BEACH, FL 32233
�J;il� INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0171
Description: 6 FIXTURES
Estimated Value: 1200
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 286 POINSETTIA ST
RE Number: 170568 0010
PROPERTY OWNER:
Name: JOHN SHAW
Address: 13028 Biggin Church Road South
JACKSONVILLE, FL 32224
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: STEEG PLUMBING CO., INC.
Address: P 0 BOX 330536
ATLANTIC BEACH, FL 32233
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 (D L R S 1 8-0 ( 7
JOB ADDRESS: .)t L DOMfe./A- PERMIT# et65,47.3;
NEW OR REPLACEMENT INSTALLATION: Project Value$ (-Z
CC
TYPE OF FIXTURE QTY TYPE OF FIXTURE QT l'
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 7,
Hose Bibs Urinal
Kitchen Sink / Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 7- Water Heater /
Other Fixtures Water Treating System
RE-PIPE: Lo
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:
o Sewer Replacement D Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads [1 Well **
**SIRWD 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 y ther state or local law regulation construction or the performance of construction.
Property Owners Name Alb/1. /pJ/ - a k(\S\C .14) Phone Number
Plumbing Company 5 j Ph.-,t, 5 A e- Office Phone Zf,/--- /°1l Fax
Co. Address: /A,/ /*/,; .9 City /4,G 6 'J State £/ Zip-3033
License Holder(Print): r,//1r —Ill State Certification/Registration# Ce' /?hg4
Notarized Signature of License Holder
Before m t s da i 0 ,tel 20 CB
i TONI GM/MERGER Signature of Notary Pub tc or/
`,�PpY a�••.
. + MY COMMISSION#FF 924951
--..;. as EXPIRES:October 6,2019
C----------
'.F `' Bonded Thru Notary Public Underwriters
01..An-
‘01 ,0,:jow, Cash Register Receipt Receipt Number
'v City of Atlantic Beach R5821 111
'boa 9'r
DESCRIPTION I ACCOUNT QTY PAID
PermitTRAK $101.00
PLRS18-0171 Address: 286 POINSETTIA ST APN: 170568 0010 $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 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R5821 $101.00
Date Paid: Tuesday,July 24, 2018
Paid By: STEEG PLUMBING CO., INC.
Cashier: JDS
Pay Method: CHECK 6180
Printed:Tuesday,July 24,2018 2:08 PM 1 of 1 is
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