771 PARADISE LN - PLUMBING r'S vL�l rJr3
�s ' „ CITY OF ATLANTIC BEACH
m
.. v800 SEMINOLE ROAD
J� VATLANTIC BEACH, FL 32233
it
.40;3 �% INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0220
Description: PLUMBING -26 FIXTURES
Estimated Value: 7000
Issue Date: 9/12/2018
Expiration Date: 3/11/2019
PROPERTY ADDRESS:
Address: 771 PARADISE LN
RE Number: 172376 0180
PROPERTY OWNER:
Name: SPRINGFIELD BUILDERS LLC
Address: 1881 BEACH AVE
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH •
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904) 247-5845 PL Ps( 8 -0z-2-0
LOB ADDRESS: -7 ) 1 TCLiratiA4G G LA.-).2 R_PEIIT# Re-6' i - O >
VEW OR REPLACEMENT INSTALLATION: Project Value$ 7/-000.00
TYPE OF FIXTURE OTY TYPE OF FIXTURE OTY
Bathtub Li Septic:Tank&Pit
Clothes Washer 1 Show.m- i_
Dishwasher I Show:a.Pan 4.___
Drinking Fountain Slop sink
Floor Drain I Three Compartment Sink
Floor Sink — Toilet: 'I
Hose Bibs a Urinal
Kitchen Sink 1 Vacuum Breakers 7--
Laundry Tray t Water Connected Appliances I
Lavatory S Water Heater I _
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE OTY TYPE OF FIXTURE OTY
Bathtub Septi,Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink ' Toilet
Hose Bibs Urin2l
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory . Water Heater
. Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor(Trap) gallons (Requires 3 sets of plans;
❑ Lawn Sprinkler System-Number of Heads 0 Well **
**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 hayc rca
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 S p VW 4i'e 14 Cl;.,
$k i id C1r Phone Number 9-04 (01b-07-if$-
Plumbing Company R A sci G-?L 0.••CA.w� Co 04ice Phone o"la 3-35-85" Fax d'3 2 5-6
Co. Address: ga3a doa-,lo stone $�v4�C dalL) - City} fc.)t.(t4 Staten Zip_222.14
License Holder (Print): Geue d. Kosei lb Sita/;e Certification/Registration# C1C d 7.7 3Q3
Cotard)ec,51ararr oil icy.n e der '''' \ ,0 �C
I ,M.rya,, LORI S.NORDGREN /�
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Notuy Public-Sun of Florida worn and subscribed before of this . REF,
7 day of
Commission•FF 947338
- l / — .� +?��. '`� My Comm.Expires Mar til.zozo �ignature of Notary Public � - - s /
i �.'a,n�' Bonded through Nations)Notary Assn. /
I
Js Cash Register Receipt Receipt Number
City of Atlantic Beach R6307
DESCRIPTION I ACCOUNT QTY I PAID
PermitTRAK $242.93
PLRS18-0220 Address: 771 PARADISE LN APN: 172376 0180 $242.93
PLUMBING $237.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 26 $182.00
STATE SURCHARGES $5.93
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.56
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.37
TOTAL FEES PAID BY RECEIPT: R6307 $242.93
Date Paid: Wednesday, September 12, 2018
Paid By: B & G PLUMBING, HEATING &AIR CONDITION!
Cashier: CB
Pay Method: CREDIT CARD 024035
Printed:Wednesday,September 12, 2018 2:43 PM 1 of 1