1253 Selva Marina Cir PLRS19-0220 30 Fixtures fart PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0220
6' _ ISSUED: 11/26/2019
`�✓ 800 SEMINOLE ROAD EXPIRES: 5/24/2020
ATLANTIC BEACH. FL 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:
1253 SELVA MARINA CIRCLE PLUMBING RESIDENTIAL PLUMBING - 30 FIXTURES $18000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
COMPANY: ADDRESS: CITY: STATE: ZIP:
STEWART PLUMBING 5457 HICKSON ROAD JACKSONVILLE FL 32207
CONTRACTING INC
OWNER: ADDRESS: CITY: STATE: ZIP:
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 30 $210.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.98
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.65
TOTAL: $271.63
Issued Date: 11/26/2019 1 of 1
Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GAY IScQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 P /- 1 1 -CZ Z-0
Phone: (904) 247-5826 Email: I?uilding-Dept@coab_uc PERMIT#: /g—b3o8
JOB ADDRESS: /0153 Jet va Martr1A Cl rc,1 Q- PROJECT VALUE $ / p, CT 0 Q
✓7 JEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub a- Septic Tank & Pit
Clothes Washer •- Shower
Dishwasher ( Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet (P
Hose Bibs 3 Urinal
Kitchen Sink ___t__ Vacuum Breakers
Laundry Tray I Water Connected Appliances
Lavatory 7 Water Heater c2_.•
Other Fixtures Water Treating System ____L_
❑VIISCELLANEOUS \'
❑Sewer Replacement 6 - /❑Back Flow Preventer
❑Lawn Sprinkler System (number of sprinkler heads)
03r-ease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑Well **SIRWD 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: bDraleSil c a tt/No WGUcb 1<,aWS1<,aPhone Number:
Plumbing Company: S4eWart PLbg Cont c ifl Office Phone: 90/0103 `SOY Fax
Co. Address: 5`457 14Icksom fPc1 City: --- -iickSonV,1(e State: FL_Zip: 322-07
License Holder: �IF'rery 3/d. State Certification/Registration #GfC(`fol sigo 6
Notarized Signature of License Holder ,
The foregoirTir r ument`las acknowledgid before me this -�da�of , 24 lin the State of Florida,
County of ` ___,.6v��L1 /
___,\
�- �� / -
Signature of Notary Public l i- ,� ` A
( '"� TON!GINDLESPERGER
`,? i• 4;_ MY COMMISSION#GG 353178 { ] Personally Known OR [ ] Produced Identification
"' 'o= EXPIRES:Odober6,2023 Type of Identification:
"FOF c�c` Bonded Thru Notary Pubic Underwriters
Updated 10/17/18
Gr lam'
S` 1�yr
°' Cash Register Receipt Receipt Number
~ City of Atlantic Beach R11151
___y
DESCRIPTION I ACCOUNT I QTY PAID
PermitTRAK $271.63
PLRS19-0220 Address: 1253 SELVA MARINA CIRCLE APN: $271.63
PLUMBING $265.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 30 $210.00
STATE SURCHARGES $6.63
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.98
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.65
TOTAL FEES PAID BY RECEIPT: R11151 $271.63
Date Paid: Tuesday, November 26, 2019
Paid By: STEWART PLUMBING CONTRACTING INC
Cashier: CT
Pay Method: CREDIT CARD 029648
Printed:Tuesday, November 26, 2019 12:40 PM 1 of 1 j