157 Belvedere St PLRS19-0075 Install h20 Heater PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0075
800 SEMINOLE ROAD ISSUED:
ATLANTIC BEACH. FIL 32233 EXPIRES:
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 BUILDIN(A
CODE, NEC, IPIVIC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
- E
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,orfecleral agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
157 BELVEDERE ST PLUMBING RESIDENTIAL instat!water heater $1309.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1705840000 SALTAIR SEC 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
FLORIDA DELTA 2716 BROADWAY CENTER BLVD BRANDON I'L 33510
MECHANICAL, INC.
OWNER: ADDRESS: CITY: STATE: ZIP:
BURCH ROBERT 157 BELVEDERE ST ATLANTIC BEACH I'L 32233-4106
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-w2y.
DESCRIVIRION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455 000 322 1000 0 $55.00
PLUMBING FIXTURES 455 FOUR 322 1000 1 57.00
STATE DBPR SURCHARGE 455-0000�208-0700 0 $200
STATE DCA SURCHARGE 455 NOUN 208 0600 0 $2.00
TOTAL:$66.00
Issued Date 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0075
800 SEMINOLE ROAD ISSUED:
---j 4 0-u ATLANTIC BEACH. FL 32233 EXPIRES:
Issued Date 2of2
"ALL INFORMATION
Plumbing Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Depti4icciab.us PERMIT#;
JOB ADDRESS: 157 BELVEDERE STREET PROJECT VALUE$1,309 00
ONEW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Showei
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Sibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater 1
Other Fixtures Water Treating System
0MISCELLANEOUS
OSewer Replacement
OBack Flow Preventer
OLawn Sprinkler System(number of sprinkler heads)
03rease Interceptor(Trap)_gallons(Requires 3 sets of plans)
[]Well**SiRWD Well Completion Form,Completed form to be submitted to the Building Department for final inspection.
DOther
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 compiled 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:BURCH ROBERT Phone Number: (904)853-6662
Plumbing Company: FLORIDA DELTA MECHANICAI_ office Phone: I866)2194MO Fax(866)219-0729
Co.Address: 8402 LAUREL FAIR CIR SUITE 111 City: TAMPA State: FIL Zip: 33610
License Holder: DIMITRE BOBEV Stf4,c, /R ation# CFC1425917
e Ce tg�
4�: -V D �Istr
Notarized Signature of Ucense Holder
The foregoing instrument was acknowledged before me this �1 By of ftiV 2011.in the State of Florida,
County of.ba. 11.�ClCCICaC4
Signature of Notary Public
Ir 07056 Personally Known OR Produced Identification
EXIJRCS:�11,=
Type of Identification:
Cash Register Receipt Receipt Numbe
City of Atlantic Beach R8729
DESCRIPTION ACCOUNT CITY PAID
PermItTRAK $66.00
PLRS19-0075 Address: 157 BELVEDERE ST APN: 170584 0000 $66.00
PLUMBING $62.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING HXTURES 455-0000-322-1000 1 $7.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE
TOTAL FEES PAID BY RECEIPT: R8729 $66.00
Date Paid:Thursday,April 11, 2019
Paid By: FLORIDA DELTA MECHANICAL, INC.
Cashier:CB
Pay Method: CREDIT CARD 6
Printed:Thursday,April 11,2019 2:00 PM I of I