5411 CAPELLA CT PLUMB PERM PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
s, PLRS19-0045
CITY OF ATLANTIC BEACH
ISSUED: 3/4/2019
800 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 8/31/2019
INSPECTIONMUST CALL • •NE LINE (904) 2+ + BY + PM FOR + INSPECTION.
ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' D+ BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READCAREFULLY.
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:
5411 CAPELLA CT PLUMBING RESIDENTIAL WATER HEATER $810.00
TYPE OF
• • GROUP:
169397 0200 SECTION LAND
• ADDRESS:
DAVID GRAY PLUMBING 6491 POWERS AVENUE JACKSONVILLE FL 32217
INC.
• ADDRESS:
NAVAL CONTINUING CARE
RETIREMENT 1 FLEET LANDING BLVD ATLANTIC BEACH FL 32233-4599
FOUNDATION INC
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.
CONDITIONSLIST OF
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
i
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 1 $7.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 3/4/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
` I CITY OF ATLANTIC BEACH PLRS19-0045
800 SEMINOLE ROAD ISSUED: 3/4/2019
9 EXPIRES: 8/31/2019
ATLANTIC BEACH. FL 32233
TOTAL: $66.00
Issued Date: 3/4/2019 2 of 2
Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
a
Phone: 904) 247-5826 Email: Building-Dept@coab.us PERMIT#: PLRS
JOB ADDRESS: 5411 Capella Court Atlantic Beach, FL 32233 PROJECT VALUE $810.00
HNEW OR REPLACEMENT INSTALLATION and/or EIRE-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
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater 1
Other Fixtures Water Treating System
❑VIISCELLANEOUS
❑Sewer Replacement
❑Back Flow Preventer
❑Lawn Sprinkler System (number of sprinkler heads)
03rease 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:Fleet Landing Retirement Living Phone Number: (904)246-9900
Plumbing Company: David Gray Plumbing Office Phone: (904) 724-7211 Fax(904) 724-5925
Co. Address: 8491 Powers Avenue City: Jacksonville State: FL Zip: 32217
License Holder: <ltlt D State Certification/Registration # CFCO22586
Notarized Signature of License Holder ,yG
The foregoing instrument was acknowledged before me this day of J:: , in the State of Florida,
County of
�ox"�,.� Notary Public State of Florida Signature of Notary Public
Grimaris Rivera ;LL�
• My Commission GG 242920
?aa Expires 07/30/2022 [ .personally Known OR [ J Produced Identification
Type of Identification:
Updated 10/17/18