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1388 Rose St. PLRS19-0071 Water Heater .;51,A6-.6,, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER JSN.p�, CITY OF ATLANTIC BEACH PLRS19-0071 J yr 800 SEMINOLE ROAD ISSUED: 4/5/2019 \c stl9 ATLANTIC BEACH. FL 32233 EXPIRES: 10/2/2019 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: 1388 ROSE ST PLUMBING RESIDENTIAL WATER HEATER $810.00 TYPE OF REAL ESTATE I BUILDING USE ZONING: SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 171063 0200 ATLANTIC BEACH SEC H COMPANY: ADDRESS: CITY: STATE: ZIP: DAVID GRAY PLUMBING 6491 POWERS AVENUE JACKSONVILLE FL 32217 INC. OWNER: ADDRESS: CITY: STATE: ZIP: TOWNSEND SHARON RENEE 960 HAGLER DR NEPTUNE BEACH FL 32266-3754 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 0 $0.00 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:4/5/2019 1 of 2 „_,A,ff PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER r '`1 CITY OF ATLANTIC BEACH PLRS19-0071 800 SEMINOLE ROAD ISSUED: 4/5/2019 •-t "'�”` ��v vi;i�'` ATLANTIC BEACH. FL 32233 EXPIRES: 10/2/2019 TOTAL: $66.00 Issued Date:4/5/2019 2 of 2 Plumbing Permit Application **ALL INFORMATION /<';:-C-- 1' , HIGHLIGHTED IN .,)1 City of Atlantic Beach Building Department 0 ., GRAY IS REQUIRED. '' ' 800 Seminole Rd, Atlantic Beach, FL 32233 --`,-34,1.,,,,,` Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: h LR59 -co7 JOB ADDRESS: 12)gf) s-e St—re—e,4— PROJECT VALUE $ eI© , OO IIVEW OR REPLACEMENT INSTALLATION and/or ORE-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 DVIISCELLANEOUS ❑Sewer Replacement ❑Back Flow Preventer ❑Lawn Sprinkler System (number of sprinkler heads) Lirease 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:TOWNSEND SHARON RENEE Phone Number: (904)463-2220 Plumbing Company: David Gray Plumbing, Inc. Office Phone: (904)724-7211 Fax(904) 724-5925 Co. Address: 6491 Powers Avenue � City: Jacksonville State: FL Zip: 32217 License Holder: t)l!J E k State Certification/Registration # CFCO22586 a/✓ ,, r ) fjloe Notarized Signature of License Holder r The foregoing instrument was acknowledged before me this 5- day of 46/ / , 20 1�, in the State of Florida, County of 0,Q 1 Signature of Notary Public ItAL' ///1"-/L- ...0 .dn' Notary Public State o Florida Gnmans Rivera ' MyCommissicnGG242920 [r Personally Known OR [ ] Produced Identification ' 0•010` e�ire,o�r�azozz Type of Identification: Updated 10/17/18