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390 PLAZA - PLUMBING PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER Al ,� CITY OF ATLANTIC BEACH PLRS19-0010 , ip 800 SEMINOLE ROAD ISSUED: 1/9/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 7/8/2019 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: 390 PLAZA PLUMBING RESIDENTIAL PLUMBING - 30 FIXTURES $18000.00 TYPE OF REAL ESTATE BUILDING USE ZONING: ! SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 169981 0000 ATLANTIC BEACH COMPANY: ADDRESS: CITY: STATE: ZIP: B & G PLUMBING, HEATING & AIR 2232 Corparate Square Blvd JACKSONVILLE FL 32216 CONDITIONI OWNER: ADDRESS: CITY: STATE: ZIP: WEBER JULIEANN E 124 14TH 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 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 30 $210.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.98 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.65 TOTAL:$271.63 Issued Date: 1/9/2019 1 of 2 PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach,FL 32233 Ph(904) 247-5826 Fax(904) 247-5845 1013 ADDRESS: 3 D ?LA PERMIT# PL 'S[9 —OO/Z NEW OR REPLACEMENT INSTALLATION: Project Value$ I 00. 00 TYPE OF FIXTURE OTY TYPE OF FIXTURE OTY Bathtub a. _ Septic:Tank&Pit _ Clothes WasherI Shower "Z- Dishwasher ..._._i_____ -_!_^ Shower Pan Drinking Fountain -�' Slop Sink Floor Drain _ Three Compartment Sink -- Floor Floor Sink Toilet K Hose Bibs 11 Urinal ._— Kitchen Kitchen Sink i Vacuum Breakers abh- Laundry Tray _____ Water Connected Appliances 7- .__ Lavatory 1 Water Heater Z Other Fixtures Water Treating System ___ RE-PIPE: (.9/ TYPE O FiXT URE OT Y TYPE OF FIXTURE Ory Bathtub Septic Tank&Pit --- Clothes Washer _ _ Shover Dishwasher Shower Pan Drinking Fountain Slop Sink • -_ Floor Drain Three Compartment Sink Floor Sink • Toilet Hose Bibs __ Urint1 __ . Kitchen Sink Vacuum Breakers _ Laundry Tray Water Connected Appliances Lavatory Water Heater ---- Other Fixtures _ Water Treating System MISCELLANEOUS: o Sewer Replacement 0 Back Flow Preventer O Grease Interceptor(Trap) gallons(Requires 3 sets of plans; O 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 suspenlied or abandoned for six months.I hereby certify that I have rca 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. Property Owners Name .I U r i Q-CI h h ("n 0 mac W A e v- Phone Number 9 0 9-Lo 10 " 3 l cfr Plumbing Company �� �L.,�� ,.44.V,..S �c• _Office Phone Cion(-Lza-1516-Fax901-2z3-17Y6 Co. Address: 2 3 L &©rtlJ a U-,A- c S City 6t.1-1-Ct—,c),(Gc State r C Zip 3 2. i4.__ License Holder(Print): 4 c_ a. ri-zo Y to Certification/Registration# C.S:G 0:IP 593 Notarized Signature of License Holder C. A ..;;ear,, LORI S.NOROGREN Sworn and subscribed before I' 7 �,•ay of �46- _eAA, 20�� grip c. Notary Public•State of Florida / / e Commission#FF 947336 Signature of Notary Public F j, • , ,t.A.�-%/, '-j,F��� My Comm.Expires Mar 10,2020 '"�,,.. Sanded through National Notary Assn. a4 t Number J � Cash Register Receipt _Receipt City of Atlantic Beach R7795 DESCRIPTION I ACCOUNT I QTY PAID PermitTRAK $271.63 PLRS19-0010 Address: 390 PLAZA APN: 169981 0000 $271.63 PLUMBING $265.00 PLUMBING BASE FEE 455-0000-322-1000 0 $55.00 PLUMBING FIXTURES 455-0000-322-1000 30 $210.00 STATE SURCHARGES $6.63 STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.98 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.65 TOTAL FEES PAID BY RECEIPT: R7795 $271.63 CITY;F.ATIANTIC BEACH 800 SENINOLE RD ATLANTIC BEAC,FL 32233 01!09,2019 13:28:23 CREDIT CARD VISA SALE Card x XXXXXXXXXXXX3386 SEQ;x: 8 Batch u: 761 INVOICE 8 Approval Code: 047686 Entry Method: Manual Mode: Online Tax Amount: $0.00 Card Code: M SALE AMOUNT $271.63 I CUSTOMER COPY I Date Paid: Wednesday, January 09, 2019 Paid By: B & G PLUMBING, HEATING & AIR CONDITIONI Cashier: BA Pay Method: CREDIT CARD 8 Printed:Wednesday,January 09,2019 1:29 PM 1 of 1 rn X,T