60 Seminole Landing Rd PLRS19-0087 Shower Pan PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0087
n ISSUED: 5/6/2019
800 SEMINOLE ROAD EXPIRES: 11/2/2019
ATLANTIC BEACH. FL 32233
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ALL WORK MUST CONFORM TO THE LUKKtF;l bin
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
F���
CE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
may be found in the public records of this county,and there may be additional permits required from other
rnmental entities such as water management districts,state agencies,or federal agencies.
60 SEMINOLE LANDING RD PLUMBING RESIDENTIAL SHOWER PAN $1200.00
— TYPE OF SUBDIVISION:
CONSTRUCTION:
• 168908 1022 BLUFFS
TURNER PLUMBING CO. 1903 HENDRICKS AVE JACKSONVILLE FL 32207
WAN KAT ALLEN L 60 SEMINOLE LANDING RD tt 10 ATLANTIC BEACH FL 32233-5945
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
455-0000.322-1000 0 $5500
PLUMBING BASE FEE $O.W
PWMBING FWURES 455-0000.322-1000 0
455-0000-322-1000 1 $7 00
PLUMBING FIXTURES $2
GE 4550000408
0 $2-0]00 0
4550000-208-0600 00
STATESTATEOBP0.5URCHAflDCA SURCHARGE TOTAL:$66.00
Issued Date:5/6/2019
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PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0087
800 SEMINOLE ROAD ISSUED: 5/6/2019
t v? ATLANTIC BEACH. FL 32233 EXPIRES: 11/2/2019
Issued Date: 5/6/2019 2 of 2
"ALL INFORMATION
Plumbing Permit Application HIGHLIGHTEDIN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dep��t(P�coab.us PERMIT q:
JOB ADDRESS: (sD See A t I h
��a_ Ln,4-)2 1=-tC• PROTECT VALUE$
❑NEW 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
Other Fixtures Water Treating System
❑MISCELLANEOUS
❑ Sewer Replacement
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler heads)
❑Grease 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/Tor local law regulation construction or the performance of construction.
Owner Name: Qtly +I'e n�I 'y rA H�'1�4 Phone Number:
I ,
Plumbing Company:Tt,r�-//v�t (�\ t��f L.� Office Phone: �gCnY Fax 591,
Co.Address: ( 9 0 3 t+ -(c,�3 p'si City: 4 h IC State:F( Zip: 3 Z?,-c,7
License Holder: �� -h � • ''L State Certification/Registration It C fG 02"�-Cp
Notarized Signature of License Holder y- J
The foregoingi trument w acknowledged before me this_ ( � G� , 20 in the State of Florida,
County of-f`�
_ Signature of Notary Publi
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'iy�. TONT GINGLESPERGER rnv CGMMIssIQVtF G9Nmf ] Personally Known OR [ ] Produced Identification C�
ftlftdlN.�I.0 a°qua ype of Identification: ( S c/ �— I� ( —�
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