248 11th PLRS18-0237 rt PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
h CITY OF ATLANTIC BEACH PLRS18-0237
ISSUED: 10/9/2018
n 800 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES:4/7/2019
• • . r . all 01
ALL
41ORK III • • • • • • • • I • • • • �
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
FE:In addition to the requirements of this permit,there may be additional restrictions applicable to this property
ay be found in the public records of this county, and there may be additional permits required from other
nmental entities such as water management districts,state agencies,or federal agencies.
JOB ADDRESS: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
24811TH ST PLUMBING RESIDENTIAL 3 FIXTURES $900.00
TYPE OF ZONING: BUILDINGSUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1702510000 ATLANTIC BEACH
COMPANY: ADDRESS:
TDG PLUMBING 4426 LOYS DR JACKSONVILLE FL 32246
• ADDRESS:
MCKNIGHT GERTRUDE S 24811TH ST ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list. Container Cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 4550000-3221000 0 $55.00
PLUMBING FIXTURES 4550000-322-1000 0 Sow
PLUMBING FIXTURES 455-0000-322-1000 3 $2100
STATE DEEP SURCHARGE 455-0000-208-0900 0 52.00
STATE DCA SURCHARGE 7 455-0000-208-0600 0 $200
TOTAL:$80.00
Issued Date: 10/9/2018 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS18-0237
ISSUED: 10/9/2018
800 SEMINOLE ROAD EXPIRES:4/7/2019
ATLANTIC BEACH. FL 32233
Issued Date:10/9/2018 2 of 2
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 n((�'� @
Lr Ph(904)247-5826 Fax(904)247-5845 P L RJ(O -vz z,7
JOB ADDRESS: .,! �t *I %T~ S-K- PERMrr# 0
NEW OR REPLACEMENT INSTALLATION: Project Values 9b J
TYPEOFFIXTURE QTY TYPEoFFixTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Chain Three Compartment Sink
Floor Sink Toilet
Hose Bibs 1 Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures y, Water Treating System �^
RE-PIPE: .J
TYPE of FIXTURE QTY TYPE oFFIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Chain 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:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads n Well **
**S/RWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
El Other T%,liI S+. wLT lJ �lw1Jt -k 90 F.Utm-
Permit becomes void if work consent 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 stale or local law regulation construction or the performance of construction.
Property Owners Name Cy)Qkx%.!J W Phone Number
Plumbing CompanOffice Phone $•4S•7,41 Fax tSs
Co. Address: , *K«- City`ZA1- State zip 1%%44
License Holder(Print): :a n! State Certification/Registration# C ct-14'L-loya
Notarized Signature c icense Holder --1�-��
worn and subscribed before me t �(da 20
ts
.AN EXPIRES:Otto!»,6,nig ignature of Notary Public C�
�+�" y Banaoe TAry Mury Publ�IMernrAea