1202 JASMINE ST - PLUMBING PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
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CITY OF ATLANTIC BEACH PLRS18-0266
800 SEMINOLE ROAD ISSUED: 11/5/2018
'Pt oills)>- ATLANTIC BEACH. FL 32233 EXPIRES: 5/4/2019
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, IPMC, 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
governmental entities such as water management districts,state agencies, or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1202 JASMINE ST PLUMBING RESIDENTIAL $3000.00
TYPE OF j REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171020 0030 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: STATE: ZIP:
CANNON PLUMBING, INC. 1718 EAST CHURCH STREET JACKSONVILLE FL 32202
OWNER: ADDRESS: CITY: STATE: ZIP:
Jasmine Land Trust#1202 1202 Jasmine Street 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 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 13 $91.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.19
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $150.19'
Issued Date: 11/5/2018 -
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PLUMBING PERMIT APPLICATION .•
CITY OF ATLANTIC BEACH •
tita 614014.40, C01%14%441111 800 Seminole Rd Atlantic Beach,FL 32233 • •
Ph(904)247-5826. Fax(904)247-5845
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JOB ADDRESS: . IA.c0. titAlv4 n 6 5+(e1ri- PERMIT#Pt- S/E' 624/
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NEW OR RE ' . CEMENT INSTALLATION: Project Value$ c?0 00460 •
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TYPE O. FIXTURE Qrr TYPE OF FIXTURE QTY
Bathtub 1Septic Tank&Pit
Clothes ' asher i Shower _ A_
Dishw .:z..'.. Shower Pan
II * ;1 .: Fountain Slop Sink •
""-----
Floor ,in Three Compartment Sink
Flan-S'. . Toilet
Hose Bi.: I Urinal
Kitchen•ink 1 . Vacuum Breakers
Laundry Tray .
Water Connected Appliances t
Lavato 3 Water Heater
Other F ' res Water Treating System
RE-PIPE: . . • • '
TYPE 0 •FIXTURE . QTY TYPE.0P FIXTURE : Of
Bathtub - Septic Tank&Pit
Clothes ' asher , Shower .
Dishw -:er Shower Pan..
D ': :: . Fountain Slop Sink I
.
Floor I 1', Three Compartment Sink
Floor S'i ,
Toilet ---
Hose Bi i, , Urinal •
Kitchen •ink . . . Vacuum Breakers
Laundry Tray ' Water Connected Appliances
Lev* . Water Heater . • ' . .•
Other F tures • Water Treating System .'' •
. .
MISCEL ' DOUS: •
0 Sewer Replacern.,t B Back Flow Preventer o Grease Interceptor{Trp) gallOns.(Requires 3 sets of plans)
0 Lawn Sprinkler •ystem-Number of Heads 0 Well' **
**5.1RWI, Well C.mpletion Form.Completed tomi to be submitted to the Building Department for final inspection.**
o Other :
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Permit becomes void f• I 1 does not contra-once within a six month period or werk is suspemied or abandoned for six months.Litcreby cerfitY that'l have read
.this application and kno, the same to be true and correct. All provisions of laws and ordinancea governing this-work will be complied with whether specified
or not. The permit does ., .give authority to violatithe provisions army other state or local law regulation construction or the performance of construction
PropertyOwners : ,,e 1.f:r 11/‘aril A . • . Phone NUmber R Of— sc- 7
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Plumbing Comps; C.-a nnA'A 6)it4 let 1 4 1-1-;"t_ Office Phone CI Ot-/iti!-.43116Fax fag- Crt-el.14
Co.Address: 1-7 I T 14444310 et h S-{-; City As k . . State.)14- Zip 32x$t
License Holder( ifi','. 4.-- trib4V.-A 11 no l't State Certification/Registration#.CpC Ik.2.6/4.•fif
Notarized Sign',-,/ . Vie. .a..148 '4 . (f2G141"------ . . • . •
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attire of Notary Public U."( OA.'V---\..,....------ - __ •
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srs; Cash Register Receipt Receipt Number
'5111111
City of Atlantic Beach R7268
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DESCRIPTION ACCOUNT QTY PAID
' PermitTRAK $150.19
PLRS18-0266 Address: 1202 JASMINE ST APN: 171020 0030 $150.19
PLUMBING $146.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 13 $91.00
STATE SURCHARGES $4.19
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.19
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R7268 $150.19
Date Paid: Monday, November 05, 2018
Paid By: CANNON PLUMBING, INC.
Cashier: CB
Pay Method: CREDIT CARD 51257
Printed: Monday, November 05, 2018 3:24 PM 1 of 1