1969 Sela Marina Dr PLRS19-0118 water heater permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
-0118
PLRS19
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 6/14/2019
EXPIRES: 12/11/2019
ATLANTIC BEACH. FIL 32233
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:
1969 SELVA MARINA DR PLUMBING RESIDENTIAL replace water heater $250.00
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1695061004 SELVA NORTE UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
AZ REMODELING & 5030 Champion Blvd Boca Raton FL 33496
PLUMBING INC
OWNER: ADDRESS: CITY: STATE: ZIP:
STULL CHARLES W 1969 SELVA MARINA DR JACKSONVILLE FIL 32233-4519
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 1 $7.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.001
TOTAL:$66.00
Issued Date:6/14/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
-0118
PLRS19
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 6/14/2019
EXPIRES: 12/11/2019
ATLANTIC BEACH, FIL 32233
Issued Date:6/14/2019 2 of 2
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC REACH
800 Seminole Rd Atlanfic Beach, FL 32233
Ph(904)247-5826 fax(904)247-5845
JOB ADDRESS.- 19Q9 SEUG MARINA DR ATLANTIC RF.ACH, EL 3223-S —Prnmrr#
NEW01k.-REP ACEMENTINSTALLATION: Project Values 250
TYPE oFFIATuRE QTY TYAPE OF FiX716RE
Satht b Septic Tank&Pit
Cloth;Washer Shower
Disn or Shower Pan
Drink' g Fountain Slop Sink
Floor rain
Three Compartment Sink
Flowor ink
i Toilet
Hose ibs Urinal
Kitcht rt Sink Vacuum Breakers
Laund y Tray Water Connected Appliances
Lavat(ry
Other �ixtures Water Heater
Water Treating System
RE-PIPE:-
..TYPE -TVJZE
QTY TYPE or FrxruRE
itthtu
..Clothe Washer Septic Tank&Pit
V Shower
Dish sher
nrip Shower Pan
Drinki ,a Fountain Slop Sink
Irl
Floor Ig�l in Urinal
Three Compartment Sink
Floor nk Toilet
Hose 13 bs
Kitcher Sink Vacuum Breakers
Laundr(Tray Water Connecte4 Appliances
LavatoiX Water Heater
Other fixtures Water TreAting System
MISCELLAN OUS:
':i Sewer Replacer lent [-- Back Flow Prevmter El Grease Interceptor(Trap)_gallons(Requires 3 sets of plans)
0 Lawn Sprinklei System-Munber of Heads L-1 Well
**VRKT'Well Impletion Form.Cornpleted—To—rmto be.subraitted'to&Build! a Department for final inspection,-�
o Other WATEE HEATER CHANGE-OUT
Pcrinif becornos"void if ork does not coninicnee within a six month period or work istuxpended or af�andoncd for six months,I hemby ocrtify that I have read
-t
his applicati.qji and k000�hc saine Lo bo true and corrcct. All Provisions of law�aAd ordinances-gov m. ing this work will be compli*d with whethyrr spccified
)r 1101. The permii Sivc authority to violate the provisions orany other state or JoW law regulation construction or the performance of construciioii,
3roperty Owners Name Phone Number (904) 241-1956
"Jumbing Comp A—ZREMQ[)F.UNG, 9, JJt,i111;1] ''!�fUNQ—Office Phone 561-305-7466 Fax
�o,Address:—50) Cham ion Blvd City JapQa Ratort State—El._Zip--3.1A96
Acense Holder(F rint): ALEXANDER ZADgM!!�2 A/Z State Ccrtification/Registration#-QEQ142fflA2
Votafized&gnatu.v of License
91 ON LE17GOLD
r
..efore me/th' dav of
0
Notary P lio Stale of Floridit.
carnninlon.0 GG 0077D3 e
Public
�Anature
KiY My Comrn WrOvJlun 30.2020
80"dea IWO g�Nalional Notaq Assn:
Cash Register Receipt Receipt Number
City of Atlantic Beach R9308
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $66.00
PLRS19-0118 Address: 1969 SELVA MARINA DR APN: 169506 1004 $66.00
PLUMBING $62.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 1 $7.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 45S-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R9308 $66.00
Date Paid: Friday,June 14, 2019
Paid By: AZ REMODELING & PLUMBING INC
Cashier: CT
Pay Method: CREDIT CARD 111581
Printed: Friday,June 14,2019 10:19 AM 1 of 1