1870 SHERRY DR N - PLUMBING rS'A.P.% PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
i CITY OF ATLANTIC BEACH PLRS18-0282
�
)1°
j 800 SEMINOLE ROAD ISSUED: 11/26/2018
<-'71,�' °';19` ATLANTIC BEACH. FL 32233 EXPIRES: 5/25/2019
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:
1870 N SHERRY DR PLUMBING RESIDENTIAL PLUMBING - 4 FIXTURES $2500.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0836 SELVA MARINA UNIT
10C
COMPANY: i ADDRESS: CITY: STATE: I ZIP:
F W FAIR PLUMBING CO. P.O. BOX 51558 JACKSONVILLE FL 32240
OWNER: ADDRESS: CITY: STATE: ZIP:
MAYHEW WILLIAM E 1870 SHERRY DR N ATLANTIC BEACH FL 32233-4517
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 0 $0.00
PLUMBING FIXTURES 455-0000-322-1000 4 $28.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$87.00
Issued Date: 11/26/2018 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 CS L RS 1 8-oz QZ
JOB ADDRESS: - 04- 410 Ay,/,' L ,, PERMIT #
NEW OR REPLACEMENT INSTALLATION: Pr 1 '•ct Value $ ZS 00
TYPE OF FIXTURE QTY TYPE • • 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: ' ri..,
TYPE OF FIXTURE QTY r \ TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower I
Dishwasher Shower Pan _i
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet -7Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement 0 Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads 0 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 specified
or not. The permit does not give authority to violate the provisions of any others or local law regulation construction or the performance of construction.
/ � � f
Property Owners Name t/V l tAk-4-Ni, � U '[he- Phone Number
Plumbing Company
>1.---,
Uk,--,4,,, PP. ,),,,3i' , Office Phone 7/' 71 c7/ Fax2 tit- 2 7'1 3
Co. Address: A. dkX f/ Fs,' City(4k 1t4 C k4 StatA Zip i-2' 9 b
License Holder (Print): i b xG Mi 1t , : -1,9srtification/Registratio OO 3 7 863
Notarized Signature of License Holder r
Sworn and subscribed befo e this' da • Atj4 �,/ 2(�f
.►►� Notary Public State of Florida
461
; Jacqueline Brooks Si nature of Notar Publ.Myci c ssronGG209482g yv �♦Explres04/08I2022l'