153 CYPRESS ST PLRS19-0021 PLUMBING PERMIT PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0021
800 SEMINOLE ROAD ISSUED: 1/24/2019
ATLANTIC BEACH. FL 32233
EXPIRES: 7/23/2019
CODE,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
' OF BEACH CODEOF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, • 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:
153 CYPRESS ST PLUMBING RESIDENTIAL PLUMBING - 11 FIXTURES $2500.00
TYPE OF
• • GROUP:
170576 0100 SALTAIR SEC 01
COMPANY: ADDRESS:
STEEG PLUMBING 1601 MAIN STREET ATLANTIC BEACH FL 32233
COMPANY INC
• ADDRESS: CITY: STATE: ZIP:
NAUMANN LOUISE M 153 CYPRESS ST ATLANTIC BEACH FL 32233-4169
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 45S-0000-322-1000 0 $0.00
PLUMBING FIXTURES 4SS-0000-322-1000 11 $77.00
STATE DBPR SURCHARGE 45S-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 45S-0000-208-0600 0 $2.00
TOTAL: $136.00
Issued Date: 1/24/2019 1 of 2
PLUMBING PERM IT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 fax(904)247-5845 ( � —
JOB ADDRESS: /!r°,'3 ,(4 'les,s 5� PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ �
TYPE OF FIXTURE Q71' TYPE OF FATURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan _
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose BibsUrinal
Kitchen Sink e~ Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE 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 1
Hose Bibs — Urinal _
Kitchen Sink �_ Vacuum Breakers
f Laundry Tray Water Connected Appliances _
Lavatory �— Water Heater f
Other Fixtures Water Treating System _
MISCELLANEOUS:
o Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
o Lawn Sprinkler System-Number of Heads ❑ Well
**,VRWD 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. 1-he 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 L 11l 5G ���yrJs�n n Phone Number
Plumbing Company ,r � �� Office Phone ��1,S/of/ Fax
Co. Address: )/""n /I/hlrt City AV AcA State f/ Zip 3,
License Holder(Print): Ce State Certification/Registration#
Notarized Signature of License Holder
TONI M NSION#FF 924951 Before met Z 4 d y o 2 _
MY CAM
EXPIRES:October 6,tots Signature of Notary Public
a Public undemb's e7" —
:', R `a BondedThruW'ry
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