85 Nicole Ln PLRS19-0168 6 Fixtures for Bathroom Remodel '''JI
r PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0168
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ISSUED: 9/13/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 3/11/2020
60
MUST CALL INSPECTI=PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL •RK MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + BUILDING
CODE, AND OF ATLANTIC BEACH • OF ORDINANCES .
ALL • i OF PERMIT APPLY, PLEASE READCAREFULLY.
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:
85 NICOLE LN PLUMBING RESIDENTIAL 6 fixtures for bathroom $23000.00
remodel
TYPE OF
• • GROUP:
169519 0830 TIFFANY BY THE SEA
COMPANY: ADDRESS:
MARCHAND PLUMBING 10139 BOOKWOOD FOREST BLVD JACKSONVILLE FL 32225
INC.
BEIER ALEXANDRA DAROS 85 NICOLE LN ATLANTIC BEACH FL 32233-5979
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.
LIST0,F CONDITIONS
�II 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 455-0000-322-1000 6 $42.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$101.00
Issued Date: 9/13/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
i CITY OF ATLANTIC BEACH PLRS19-0168
800 SEMINOLE ROAD ISSUED: 9/13/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 3/11/2020
Issued Date: 9/13/2019 2 of 2
1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904)247-5845
JOB ADDRESS: 86 �i� �C h PERMIT# TLRSI�—a/(pb
NEW OR REPLACEMENT INSTALLATION: Project Value$ o-3
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
RE-PIPE:
T3PE OF FIXTURE QTY T3PE 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 Grease Interceptor(Trap) gallons(Requires 3 sets of pl.
Lawn Sprinkler System-Number of Heads L- Well **
VR WD Well Completion Form. Completed form to be submitted to the Building Department for final inspectioi
Other
Permit becomes void if xNork does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have
this application and know the same to be true and correct. All provisions of laws and ordinances governing this work w ill he complied with whether speci
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 constructic
Property Owners Name O'4 i�-a Phone Number
Plumbing Company rAOM61Inc, Office Phone V85-5-155 Fax
Co. Address: to( BU City 30X State f l Zipc5
License Holder(Print): t State C rtificattiion/Registration#_9j;& C � r)
Notarized Signature of License Holder �L' 1 d-3b`tyv I "3�-9
:�P:ati►u ZENAIDARABANAL worn and subscribed before me this day of St 20
Commission#GG 190223
:ry ' E Aires March 6,2022
x
°P Bolded Thu Toy fain 1=wm ce 800,185.7019