347 7TH ST PLRS18-0297 PLUMBING RESIDENTIAL PERMIT PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS18-0297
800 SEMINOLE ROAD ISSUED:
ATLANTIC BEACH. FL 32233 EXPIRES:
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF i '
CODE, OF • OF ORDINANCES .
ALL • • OF PERMIT APPLY, PLEASE
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:
347 7TH ST PLUMBING RESIDENTIAL PLUMBING - 40 FIXTURES $10000.00
TYPE OF
• • GROUP:
169929 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
NELSON PLUMBING CO. 11624 -1 DAVIS CREEK ROAD EAST JACKSONVILLE FL 32256
INC.
• ADDRESS:
ALEXIS ASPLUNDH 99 ORANGE ST NEPTUNE BEACH FL 32266
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 • •
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 0 $0.00
PLUMBING FIXTURES 455-0000-322-1000 40 $280.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $5.03
STATE DCA SURCHARGE 455-0000-208-0600 0 $3.35
TOTAL: $343.38
Issued Date: 1 of 2
Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
a sa City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 P LF-11 c: — C z9 7
Phone: (904) 247-5826 Email:I. Bulldlng-Dept@coab.us PERMIT#: 03S
JOB ADDRESS: 3q-7 -7tJ5 �T'94 Ct- PROJECT VALUE$ 10000
✓❑NEW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub ( Septic Tank & Pit
Clothes Washer Shower 3
Dishwasher �_ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs _� Urinal
Kitchen Sink i Vacuum Breakers
Laundry Tray ( Water Connected Appliances
Lavatory Water Heater
Other Fixtures 3 Water Treating System
CMISCELLANEOUS i V
❑Sewer Replacement
❑Back Flow Preventer
❑Lawn Sprinkler System (number of sprinkler heads)
❑Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑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 other state or local law regulation construction or the performance of construction.
Owner Name: (_OOMT*( G dvt SUVItTIO&J - d5P00JN Phone Number:
Plumbing Company: /IIE�Soo-j 10k woriSIA06 nd _i✓e. Office Phone: 2,6Z. gg8q Fax
Co. Address: 116zq-1 PAVIS ee4ftL Q E I 014Vt lie State:L Zip: 322 s6
License Holder: +^o /VZr- S Dom✓ S r ' ' ti e - tration # oZ a 37y
Notarized Signature of License Holder
The foregoin instrum nt was acknowledged before me this day of 20]S, in the State of Florida,
County of
USA P•B Signat of Notary Public YU
MY COMMISSION#FF 900342
b a EXPIRES:November 16.2019
Bonded ThNNotary PuDGcUnderwrte [ Personally Known OR [ ] Prod ced Identification
Type of Identification:
Updated 10/17/18