750 Bonita Rd PLRS19-0199 Sewer Replacement �S"`'�"% PLUMBING RESIDENTIAL PERMIT PERMIT NUMBERf s� PLRS19-0199
__________
CITY OF ATLANTIC BEACH
f�a°' "' ISSUED: 10/24/2019
\\ 800 SEMINOLE ROAD
`�U111)� ATLANTIC BEACH. FL 32233 EXPIRES: 4/21/2020
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:
750 BONITA RD PLUMBING RESIDENTIAL sewer replacement $3000.00
TYPE OF 1 REAL ESTATE I ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171096 0000 ROYAL PALMS UNIT 01
COMPANY: ADDRESS: CITY: . STATE: ZIP:
F.W. FAIR PLUMBING CO. P.O. BOX 51558 JACKSONVILLE FL 32240
OWNER: ADDRESS: CITY: STATE: ' ZIP:
ZUBIA HECTOR OT2 750 BONITA RD ATLANTIC BEACH FL 32233-4207
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.
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 $2.00
TOTAL: $66.00
Issued Date: 10/24/2019 1 of 2
- '`'%�, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
^J'' ;, , PLRS19-0199
CITY OF ATLANTIC BEACH
, ISSUED: 10/24/2019
800 SEMINOLE ROAD
"O's»r ATLANTIC BEACH. FL 32233 EXPIRES:4/21/2020 i
Issued Date: 10/24/2019 2 of 2
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: 7/�,/0 cA )/2/11(ii . 7 (j PERMIT # Pa2-St4-p(45
NEW OR REPLACEMENT INSTALLATION: Projec Value $(3, 0--...Q,,
TYPE OF FIXTURE QTY TYPE OF IX!URL y
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:
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
(lose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
*ewer Replacement LI Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ 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.
Property Owners Name 2V13\1:1 Phone Number l9 ?3Cr
Plumbing Company , k F4
( !( �"n Jiyl�/V ( Office Phone(//' .71q/ Fax q1- 2 7.- -3
Co. Address: A & 1k S7 STY City14X k‘---ii C )4 State- Zip2 2' 7 b
License Holder (Print): � G2J f-/4 ilt tot Certification/Registratio pd 3-75-6) .2
Notarized Signature of License Holder
,,��r4 Notary Public State of Florida Sworn and subscribed efore me this_" day of, k�a" 20/9
`1'. Jacqueline Brooks �
My Commission GG 204482
" Signature of Notary Publi / "3" ,_tiOIA4,40
��� Expires 04108/2022 /