1820 N SHERRY DR PLUMB PERM PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0028
,x 800 SEMINOLE ROAD ISSUED: 1/29/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 7/28/2019
INSPECTIONMUST CALL • • • t FOR • •
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITIONt OF • '
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:
1820 N SHERRY DR PLUMBING RESIDENTIAL PLUMBING - 10 FIXTURES $1500.00
TYPE OF
ZONING: :D •
i • GROUP:
172020 0776 SELVA MARINA UNIT
10B
COMPANY: ADDRESS:
ROLLAND REASH 11606 COLUMBIA PARK DRIVE EAST JACKSONVILLE FL 32258
PLUMBING
• ADDRESS:
YOUNG SARAH L 1820 SHERRY DR N 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.
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 4S5-0000-322-1000 10 $70.00
STATE DBPR SURCHARGE 4S5-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 1/29/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
r Ss� PLRS19-0028
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ISSUED: 1/29/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 7/28/2019
TOTAL: $129.00
Issued Date: 1/29/2019 2 of 2
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
RPh xx
/(904) 247-5826 Fax 247-5845
JOB ADDRESS: ��aC C� !/y �i44 �'7 0 f' PERMIT'# 46 !�3
NEW OR REPLACEMENT INSTALLATION: Project Value$ Z--!!5-00 , 00
TYPE of FIXTURE QTY TYPE of FIXTURE QTY
Bathtub Z Septic Tank&Pit
Clothes Washer Shower Z
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 9,4* D
Water Treating System
RE-PIPE: TYPE of FIXTURE QTYTYPE 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
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 **
** SJR WD Well Completion Form. Completed form to be submitted to the Buildmg 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 authEcc—
' e the pro ' ns of any other state or local law regulation construction or the performance of construction.
Property Owners Name .a/b� Phone Numbe�
Plumbing Company GX05 Office Phone;�x.59 Fax. --O
Co. Address City C%�XState ZiJ
License Holder(Print): 4 tat ertification/Registration
Notarized Signature of License Folder
MELODY L DEI�PSEY Sworn and subscribed before me this day of S)AT 20 Int
••:�..'''•-
IIYCOWASSION#GG Signature of Notary PublicNl
EXPIRES:SWWnbw 17,2022