370 1st PLRS18-0268 PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS18-0268
800 SEMINOLE ROAD ISSUED: 11/2/2018
T' ATLANTIC BEACH. FL 32233 EXPIRES:5/1/2019
CODE,MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PIVI FOR NEXT DAY INSPECTION.
AND CITY OF • • OF ORDINANCES .
ALL CONDITIONS OF
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.
• . ADDRESS:
3701ST ST PLUMBING RESIDENTIAL $4100.00
TYPE OF TATE • BUILDINGSUBDIVISION:
• • GROUP:
169752 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
STYLES CONSTRUCTION, 1537 PENMAN RD SUITE A JACKSONVILLE FL 32250
INC. BEACH
• ADDRESS:
WOODSJEFFREYC 3036TH ST ATLANTIC BEACH FL 32233-5347
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 4550000.322-1000 0 $55.00
PLUMBING FIXTURES 455-0000322-1000 10 $70.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 52.00
STATEXASURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$129.00
Issued Date'. 11/2/2018 1 of 2
(1 .
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS18-0268
CITY OF ATLANTIC BEACH ISSUED: 11/2/2018
800 ICBEA H.ROAD EXPIRES: 5/1/2019
ATLANTIC BEACH, F132233
Issued Date: 11/2/2018 2 oft
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH g
800 Seminole Rd Atlantic Beach, FL 32233 p LK-n S 18— b2�O"
Ph(904)247-5826 Fax(904)247-5845 1
JoB ADDREss: 370 1 St S4 PERMIT# RES
NEW OR REPLACEMENT INSTALLATION: Project Value S#q/ 00.00
TYPE OFF/xmRE QTY TIPEOFFIXTURE QTY
Bathtub I Septic Tank&Pit
Clothes Washer Shower I
Dishwasher Shower Pan I
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs I Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 02 Water Heater I
Other Fixtures Water Treating System
RE-PIPE:
TYPE oFFLXTURE QTY TYPE of FIXTURE 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 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well !*
**SJRWD Well Completion Form. Completed form to be submitted to the /Building Department for final inspection.**
❑ Other k Gl,e4 2/I d 17ia _kG,2 ti TCMOdeI
Permit becomes void if work does not 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 tine and torten. All provisions of laws and ordinances governing ibis work will becomplied 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 W 00 d s e-aa4/ C- Phone Number
Plumbing Companye5 5Mi'('6 (��vrt li�eo Office Phone o2y/ —y/31 Fax
Co. Address: 1637 Iden~ rd. '# D Citr 3aX Feo,Ck statel_G.zip .3,�Q S0
License Holder(Print): 2S W. Sri -t[7p���State Certification/Registration# CFL 14.Za&y
Notarized Signature of License Holder��'4; _
'u'j^."•.. JNNE D.SMITH Sworn and subscribed before me this 2 __ARN ofO- ei20lk_
rtt' ry*F'r MYfAM11tSSI0N Nnri 25Sf31
Pf ExPII:Es:septemhars,zon Signature of Notary Pub
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