11 Forrestal PLRS18-0263 PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS18-0263
ISSUED: 10/29/2018
800 SEMINOLE ROAD EXPIRES:4/27/2019
ATLANTIC BEACH. FIL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPIVIC, AND CITY OF ATLANTIC BEACH CODE 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
government I entities such as water management districts,state agencies,4
�PIMII-
11 FORRESTAL CIR PLUMBING RESIDENTIAL Sewer Replacement $5000.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
ATLANTIC BEACH VILLA 4
1717480000 01
ble to this party
NOT CE add he e e his pe it,th be cd a esun cuor's a PP from.
F � -t r qu' -e-ts of t 'm e e may - -t-- 1 I r .1_pe equBted It 1prro
I I 't nt
that May be f.0 d In the public ce�-'ds-f this county,and there may be add t... I 'mts es
governmental en 'I asw. m ment 'stncts,'ta agent, so or f. " ag.mc
In te, amage d te e d
COMPANY: ADDRESS: CITY: STATE: ZIP:
METRO ROOTER 8892 NORMANDY BLVD JACKSONVILLE FL 32221
OWNER: ADDRESS: CITY: STATE: zip:
WRIGHT LORI 11 FORRESTAL CIR N ATLANTIC BEA" FIL 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.
7!MM COUNT QUANTITY PAID AMOUNT
DESCRIPTIOI AC
IPTIO�
PLUMBING BASE 1EE III Gojo 322 1WO 0 $5500
455�000�322-10co 0 MUG
N-- $2.0D
s TPATUI�13 B LPREZ11U. c 455-00))208-07M a
ITATI DCA IURCH4RGI 455-DIXO-101 06M 0 $2.00
TOTAL:$59.00
issued Date: 10/29/2018 1 of 2
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: —11 FORRESTAL CIRCLE N____ ATLANTIC BEACH
ftimrr# __R-f — 6243
=5;tff
NEW OR REPLACEMENT INSTALLATION: Project Value$ S'0 0
TYPE oF FixTuRE QTY TYPE oF FlxTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Fluor Drain Three Compartment Sink
Fluor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heiner
Other Fixtures Water Treating System
RE-PIPE:
TYPEOFFIXTURE QTY TYPE oF FixTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Showerlan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
How Bibs Urinal
Kitchen Sink Vacuum Breakcrs
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
*Sewer Replacement El Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
* Lawn Sprinkler System-Number of Heads [-i Well
**SJ,RWD Well Completion Form. Completed-f—ormtobe submitted to tffe—Building Department for final inspection."
Li Other
Permit becomes void ifwrokdoes not commence within a sixuranwhineriod or work is suspended orabandoned for six months.I hereby ceftify that I have read
this application and know the sarne,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 violm the provisions of my other state or local law regulation construction or the performance of construction.
9
Property Owners Name Lori Wright Phone Number 240-422-3832—
Plumbing Company Metromoter[Wind River Environmental
Co. Address: 8892 Normandy Blvd City Jacksonville
State Fl, —71--
P
as State Certification/Registration#4�2��79
License Holder(Print):: hArd 6
JAV'M o iceme Ider
day of 20
S in and subscribed before me this
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,Fl,32233
Ph(904)247-5826 Fax(904)247-5845
JoB ADDREss:—11 FoRRESTAL CIRCLE N ATLANTIC BEACH
PERMIT#
Signature of Notary Public