375 3rd PLRS18-0247 PLUMBING RESIDENTIAL PERMIT PERMITNUMBER
CITY OF ATLANTIC BEACH PLRS18-0247
ISSUED: 10/18/2018
800 SEMINOLE ROAD EXPIRES:4/16/2019
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ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814
Y 4 PM FOR NEXT DAY INSPECTION.
ALL • • • • • • EDITION t OF • • .A BUILDING
CODE, AND CITY OF • • OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: I VALUE OF WORK:
375 3RD ST PLUMBING RESIDENTIAL $1000.00
TYPE • SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:•
169824 0015 ATLANTIC BEACH
ADDRESS:
JACKSONVILLE FL 32240
ADVANTAGE PLUMBING 880 MAYPORT RD BEACH
• ADDRESS:
GOLOMBEK ELLEN JOAN 2001 LINCOLN ST UNIT 1524 DENVER CO 80202
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.
FEES
=STATEDBPR
ION ACCOUNT QUANTITY PAID AMOUNT
SE FEE E455-MM209-07M
-0000-3221000 0 $5500
%TURES -0000-322-1000 0 $GW
MURESE -013223000 2
RCHARGE 0 $2WCHARG E 5-0000-ZU-0600 0 $2.00
TOTAL:$73.00
Issued Date: 10/18/2018 `-z-e`-c
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 klr5
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JOB ADDRESS: 3 S_ 3fil 7,J PERMIT# -03Y
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NEW OR REPLACEMENT INSTALLATION: ProjectValues 1000
TYPE oFFIXTURE QTY TYPE oFFIXTORE 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 Z Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Hester
Other Fixtures Water Treating System
RE-PIPE:
TYPE oFFIXTT/RE QTY TYPE oFFIXTuRE 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:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 seta of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well '•
**S/RWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other
Permit biomes void if work does not commence within a six month period or work is suspended or abandoned for sin months.I hereby certify that 1 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 mt. The permit does not give authority to violate the provisions of any other state or local law regulation contraction or the performance of construction.
Property Owners Name Phone Number J 13 75°8' S
Plumbing Companyk/; 1 Office Phone,?-177- Y 6 coax
Co. Address: A642/% & City lla_ _State Z7—Zip�.�1
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License Holder(Print): /State fication/Registration
Notari ed Si nature o License Holderikr K ��ILlP
j'rs NO1ry vwn StalsoIwora andsubscribed fore qday of �Lr �t 20 *
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0i,,,;el lapin osnxmu ignature of Notary Public