1902 N. Sherry Dr. PLRS19-0057 Replace water heater 7.41i11,,,„.x
PLUMBING RESIDENTIAL PERMITPERMIT NUMBER I
CITY OF ATLANTIC BEACH PLRS19-0057
J ~~ 800 SEMINOLE ROAD ISSUED: 3/20/2019
-�r �%' EXPIRES: 9/16/2019
ATLANTIC BEACH, FL 32233 I
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:
1902 N SHERRY DR PLUMBING RESIDENTIAL replace water heater $900.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0832 SELVA MARINA UNIT
10C
COMPANY: ADDRESS: CITY: STATE: ZIP:
ATLANTIC COAST 3653 REGENT BOULEVARD, #305 JACKSONVILLE FL 32224
PLUMBING CORP.
OWNER: ADDRESS: CITY: STATE: ZIP:
PETERS DONALD E 1902 SHERRY DR N ATLANTIC BEACH FL 32233-4520
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 1 $7.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$66.00
Issued Date: 3/20/2019 1 of 2
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----•• =1-4-,,'= PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
'' CITY OF ATLANTIC BEACH PLRS19-0057
ISSUED:SEMINOLE ROAD SSUED: 3/20/2019
91119r ATLANTIC BEACH, FL 32233 EXPIRES: 9/16/2019
Issued Date: 3/20/2019 2 of 2
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
,r. G
Ph
(904) 247-5826 Fax (904)247-5845
JOB ADDRESS: /7 4 a s'/err I, r. /�or rJ
.�.,.�. PEl2NITT# P( (L -S i ct-00.3 9-
NEW OR E LACEMENT NSTALLATION: Project Value$ (I0(i'
TYPE OF Fj rr= Qn' TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes WasherShower
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 /
Other Fitures _.__` Water Treating System
.E-PIPE:
TYPE or FIXTURE QTY TYPO OF FXXTUR e' QTY
Bathtub Septic Tank&Pit
Cloth9S Washer Shower
Dishwasher _ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
FIoor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers —
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System '^
ISCELLANEOUS: •
Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Lawn Sprinkler System-Number of Heads 0 Well **
SJRWD Well Completion Fame_ Completed form to be submitted to the 3ui1d ng Department for final inspection_**
Dther
nit becomes void if work does not commence within a six month period or work Is suspended or abandoned for six months.X hereby certify that I have read
application and know the same to be true and Correbl. All provisions of laws and ordinances governing this work will be complied with whether specified
of The permit does not give authority to violat the provisions of any other state or local law regulation construction or the performance of construction,
perty Owners Name O /,%G 71`Z rf _Phone Number `f 77 D 9`f/ .
mbing Company.47'19)1"- l' �o/95- (ed. �j eo yp Office Phone_ f7. 5,227f Fax ‘ .5"--.33
Address:,%..5',Y ,e/./ "i/1 30-5- ` City -�6 State e Zip 3 ""/
eerie Holder(Print): (v/c4/R5 �'.f lW UItI – " ' =te Certiification/Registration# ( ' LO 5,✓i0
'arized Signature of License Holder le_ A_
I/
Before me this Ao4' ) day of "r . 20! _
Signature of Notary Public d7- _ (----
i.,-;"'44;z:._ DIANE 0.ROCHE
„_ MY COMMISSION#GG 117147
—, --- _ ---. ,,,.,,,, ._,..--. . t.,,,r''f p; S:June 21,2021
P, ; Bonded Thru Notary Public Underwriters