190 16th PLRS18-0261 PLUMBING RESIDENTIAL PERMIT PERMITNUMBER
CITY OF ATLANTIC BEACH PLRS38-0261
800 SEMINOLE ROAD ISSUED: 10/29/2018
ATLANTIC BEACH, FL 32233 EXPIRES:4/27/2019
MUST CALL INSPECTION • • r + • • • • INSPECTION.
• • • • ' • • • • r • • • • + LIWW
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE 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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
19016TH ST PLUMBING RESIDENTIAL $6000.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
• • GROUP:
1718810000 MANDALAY
COMPANY: DD
AA BADCO PLUMBING LLC 3139 ANGORA BAY DR MIDDLEBURG FL 32068
• ADDRESS; CITY: STATE: ZIP:
BOLE KATHERINE E 19016TH 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 . r
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
FEES
DESCRIPTION ACCOUNT I QUANTITY
PLUMBING BASE FEE 455-W00-322-1000 0 $55.00
PLUMBING FIXTURES 455-W06322-SOW 4 $2810
STATE OBPR SURCHARGE 455-0000208-0TW 0 $210
STATEOCASURCHARGE 455-0000-208-0900 0 Sam
TOTAL:$87.00
Issued Date: 10/29/2018 1 of 2
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 y�
/q Ph(904)247-5826 Fax(904) 247/-5845 PLT,S
JOB ADDRESS: / /�7 09�L.e,., �rr 13d' 2Z PERMIT NU f}/1,?00217
NEW OR REPLACEMENT INSTALLATION: Project Value s "a
TYPE oFFIXTURE 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 Z
Lavatory �_ Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPEoFFtXTURE QTY TYPEOFF/XTURE 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
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 true and correct. All provisions of laws and ordinances governing this work will be complied with whether spgcified
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 kl l e ML ,P_ �jEy��,_ _Phone Number90 It—,2 ar, - a e yA
Plumbing Company 4f24tdt12 2145 5 l/GG Office PhonQP/-S�/- 3�mFax
Co. Address:�(,j��i 7a1 /t City M,Wa64,L-^,,e5 State Zip 3>0&k
License Holder(P2i in "ate( State Certification/Registration 4 Lf PC 057cy S�
Nota,i
ay;,.... .i&3-c 3025MA and subscribed b this Z—of c 204
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P^_' ,,._.$i ore of Notary Public