1918 Hickory Ln PLRS19-0128 plbg permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
`
_ CITY OF ATLANTIC BEACH PLRS19-0128
800 SEMINOLE ROAD ISSUED: 7/3/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 12/30/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' DA 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.
• . AbD • OF • •
1918 HICKORY LN PLUMBING RESIDENTIAL replace 3 fixtures for interior $1900.00
remodel
TYPE OF
ZONING: :D •
• • GROUP:
172020 1314 SELVA MARINA UNIT
12B
COMPANY: ADDRESS:
TURNER PLUMBING CO. 1903 HENDRICKS AVE JACKSONVILLE FL 32207
OWNER:--- ADDRESS:
BROWN LORRAINF 1918 HICKORY LN ATLANTIC BEACH FL 32233
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 . . •
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 45S-0000-322-1000 3 $21.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$80.00
Issued Date: 7/3/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0128
CITY OF ATLANTIC BEACH
ISSUED: 7/3/2019
J,t ,T 800 SEMINOLE ROAD EXPIRES: 12/30/2019
ATLANTIC BEACH, FL 32233
Issued Date:7/3/2019 2 of 2
f L f Sr--o ( '�- �1 (,-f)
s 1i� Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
n
800 Seminole Rd, Atlantic Beach, FL 32233 Q c
iPhone:�((90L4)) 247L-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: t al y PROJECT VALUE$ d C'�•''
F-1 NEW OR PLACE T INSTALLATION and/or El RE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub R 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 or local law regulation construction or the performance of construction.
Owner Name: Phone Number:
Plumbing Company: ~f��-� ✓ �-+w�4 - Office Phone: -ScIG —_7 Fax 31(9 —70
Co. Address: C C1 �fi��s AJc City: -I SC State: '( Zip: 2 Zs
License Holder: Wv�� +� ✓.�� f State Certification/Registration # (-'FL..52-1���Q
Notarized Signature of License Holder 1. \�) "4
The foregoing instrument was acknowledged before me this day of TCt 0 9n the State of Florida,
County of DLj_ j it.
Signature of Notary Public -
] Personally Known OR [�,}�Produ d 01�)ntification
JENNIFERJOHNSTON 1 Q
MY COMMISSION#GG 042984 Type of Identification: �� S �► o�S c
:o EXPIRES:October 27,2020
Fo d�P
Updated 10/17/18
Bonded Thru Notary Public Undenaiters