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801 Begonia St PLRS19-0223 16 Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER JSitje, PLRS19-0223 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 12/4/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 6/1/2020 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: 801 BEGONIA ST PLUMBING RESIDENTIAL INSTALL 16 FIXTURES FOR $6000.00 NEW RESIDENCE TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170927 1030 ATLANTIC BEACH SEC H COMPANY: ADDRESS: CITY: STATE: ZIP: HOFFMAN PLUMBING INC P 0 BOX 65058 ORANGE PARK FL 32065 OWNER: ADDRESS: CITY: STATE: ZIP: BEATY MARVIN M 801 BEGONIA ST ATLANTIC BEACH FL 32233-1711 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. a .t„ '�c�c:a , "^` �=!.'.x'- t%+ �l s 3;�+k `�, �a y�.�� p:-s3..�. . - •,w.< _. a ... �. .e.. _.u ..u.;..,.we, ,-:.P __... �.. DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT PLUMBING BASE FEE 455-0000-322-1000 0 $55.00 PLUMBING FIXTURES 455-0000-322-1000 16 $112.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.51 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$171.51 Issued Date: 12/4/2019 1 of 2 — Misr PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD PLRS19-0223 � ii: ISSUED: 12/4/2019 01:9% ATLANTIC BEACH, FL 32233 EXPIRES: 6/1/2020 Issued Date: 12/4/2019 2 of 2 PLUMBING PERMIT APPLICATION 0_,\ CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904)247-5826 Fax (904) 247-5845 ©L ; G1_ of �3 JOB ADDRESS: el) 0 I /31...51 Cj(')//// - j PERMIT# !i(J3414, 60 NEW OR REPLACEMENT INSTALLATION: Project Value$ O TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub I Septic Tank&Pit Clothes Washer Shower p2 Dishwasher _,L__ Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet .3_ Hose Bibs Urinal Kitchen Sink _, Vacuum Breakers Laundry Tray Water Connected Appliances / Lavatory 3 Water Heater I 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 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 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,t 120, --rt' 111111111191111, WM Phone Number Plumbing Company 110#111.0-4/A/ /) 14/0/1 4/r?5 jrZ�`C.. Office Phone 37 0) Fax Co. Address: 17 a go/ 6S'0 ST City ©°e State 4 Zip 3t'O des' License Holder(Print): (.i(tiis#161,174`1 Stat - • , - • •.0.1p... MELODY HO - N Notarized Signature of License Holder /, .4 4 r Commission I G6 056408 • :: p•-, xpires'ece r 1 I Sworn and sues 4 ed before me thi- ''`�°�� "j eoi1 r F'"'"s "'°8 eoasasaos 201 F/ / Signature of N.tart'Public / , ,(______---- C yL`Jrly,=v‘ Cash Register Receipt Receipt Number 7.5 yr City of Atlantic Beach R11201 DESCRIPTION I ACCOUNT I QTY PAID PermitTRAK $171.51 PLRS19-0223 Address: 801 BEGONIA ST APN: 170927 1030 $171.51 PLUMBING $167.00 PLUMBING BASE FEE 455-0000-322-1000 0 $55.00 PLUMBING FIXTURES 455-0000-322-1000 16 $112.00 STATE SURCHARGES $4.51 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.51 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL FEES PAID BY RECEIPT: R11201 $171.51 Date Paid: Wednesday, December 04, 2019 Paid By: HOFFMAN PLUMBING INC Cashier: CB Pay Method: CHECK 1478 Printed:Wednesday, December 04, 2019 1:18 PM 1 of 1 IF