371 3rd PLRS18-0271 PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS18-0271
+� ISSUED: 11/14/2018
800 SEMINOLE ROAD EXPIRES: 5/13/2019
u ATLANTIC BEACH. FL 32233
MUST CALL
Y 4 PM FOR NEXT DAY INSPECTION.
• ,K MUST INSPECTION• • . • • • • r OF • • • , BUILDING
CODE,ALL
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.
New Fixtures for Kitchen $2000.00
371 3RD ST PLUMBING RESIDENTIAL Remodel
TYPE • SUBDIVISION:
•
CONSTRUCTION: NUMBER: GROUP:
169823 9000 ATLANTIC BEACH
COMPANY: ADDRESS:
WILLIAM'S BIG BOYJACKSONVILLE FL 32250
PLUMBING INC
516 SOUTH 11TH AVE BEACH
OWNER: ADDRESS:
FILERS ELIZABETH A 371 3RD ST ATLANTIC BEACH FL 32233-5231
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.
"DESCRIP.T1,01N ACCOUNT TOMA
FEE
455-0000-322-1000 $
PW MBING FI%TURES
455-0000-333-1000
STATE OBPR SOflCHARGE
4S5(Con 08 0)00 STATE DCA SURCHARGE4550000308-0
Issued Date:11/14/2018 101`2
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
7 Ph(904)247-5826 Fax(904)�;H247-5845 1� l�J v
JoBADDREss: 37/ 'S-N PERMr1'# O�
NEW OR REPLACEMENT INSTALLATION: Project Values Zoo
TYPE oFDXWRE QTY TYPE oFFixruRE 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
RE-PIPE:
TYPE oFFixTURE QTY TYPE oFFIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Florgn� SlopSink
Drinking
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 `*
**SIRWD 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 sec months.I bereby mrtify that I have read
this application and know the same to he true and mired. All provisions of laws and ordinances governing this work will be complied 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 Phone Number
Plumbing Company W— 3 i� '6 a ` lu b m q Office Phone IN - K�6o Fax
Co.Address: 5—/Le 1 9, 6 pc
City Ya, �%, State �- Zip ;L25'd
License Holder(Print): W c1101k GCOCDE-7A) State Certifrcation/Registmtion# I-Y Doo '295 -
Notarized Signature of License Holder 24-,
F•' JAMIE D.SUN Sworn and subscribed before me this 'ay of Ol 20�
MY C06uns510M B GG 2$5331
e' ExPIaEs:samaml,arazo2z Signature of NotaryPubh
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