333 2ND ST - SEWER TAP '' \s\ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
?=�' ATLANTIC BEACH,FL 32233
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INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-1500
Job Type: PLUMBING ONLY
Description: sewer tap for 333 2nd St 15 sfr 1211
Estimated Value:
Issue Date: 6/24/2015
Expiration Date: _ 12/21/2015
PROPERTY ADDRESS:
Address: 333 2ND ST
RE Number: None
FEES:
SEWER TAP FEES $2.900.00
Total Payments: $2,900.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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x 4
CITY CI ATLANTIC 1.Z1�1
•
PUBLIC UTILITIES' ` (-`� - I2UQ Sandpiper Lane ATLANTIC REACH,F L 32233
<. ...
(9G4) 270-2535 or (9(14) 247-5874
NEW WATER/SEWER,WATER/SEWER, TAP REQUEST
Date: ..5---Z/-/S Project Address: 3 _
No. of Units: Commercial Residential V
—_, Mufti-Family
New Water Tap(s)&Meter(s) 3/ ,,
Meter Size(s) y
New Irrigation Meter Upgrade Existing Meter from
to (size)
New Reclaimed Water Meter Size New Connection to City Sewer s,
Name: —�
Applicant Address:
City: State:
Phone Number: Zip
Email Address Cell Number:
Fax:
Signature:
(Applicant)
APPlication# SF- CITY STAFF USE ONLY
K- rZ " �
Water System Development Charge
Sewer System Development Charge $ 0 3-v,
Water Meter Only : / O
Reclaimed Meter Only $ S OCR
$
Water Meter Tap
$
Sewer Tap
$___ _<___:1 (notes)
Cross Connection $ -Sr. Dp
Other $
TOTAL $ f 2 2S. Go
APPROVED: ale Ibfiam., l�r. 1
APPROVED.l I'�T�' �fi '(Deputy Director r�7G:or Authorized orized Signature) ALL TAP REQUE'ST MUST BE .
BEFORE FEES CAN RE ASSESSED
4' ' s� ATLANTIC BEACH
Jai=`s. PERMIT RECEIPT
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PERMIT DESCRIPTION: NEW HOME
PERMIT NUMBER: 15-SFR-1211 •
ADDRESS: 333 2ND ST
OWNER:
CITY OF ATLANTIC BEACH
FEES DUE: 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
BUILDING PERMIT FEE $1,470.00
PHONE (904) 247-5855
Cashier Id: aspcust\atlblae
Receipt Date: 6/23/2015
ENG REV RESIDENTIAL BLD $100.00
Receipt Number: 05-67047
Job ID: 15-SFR-1211 - NEW HOME BLDGFEF_ B
UILDING PERMIT FEE $1,470.00
PLAN CHECK FEES $735.00 Job ID: 15-SFR-1211 - NEW HOME ER - ENG RE
V RESIDENTIAL BLD $100.00
SEWER SDC-SYSTEM DEV CHG $4,050.00 Job ID: 15-SFR-1211 - NEW HOME PC - FLAN C
HECV FEES $735.00
Job ID: 15-SFR-1211 - NEW HOME 55 - SEWER
STATE DBPR SURCHARGE $22.05 SDC-SYSTEM DEV CHG $4,050.00
Job ID: 15-SFR-1211 - NEW HOME SS - STATE
DBPR SURCHARGE $22.05
UTIL REV RESIDENTIAL BLDG $100.00
Job ID: 15-SFR-1211 - NEW HOME UR - UTIL R
EV RESIDENTIAL BLDG $100.00
WATER CONNECT/TAP& METER $185.00 Job ID: 15-SFR-1211 - NEW HOME W3 - WATER
CONNECT/TAP & METER $185.00
Job ID: 15-SFR-1211 - NEW HOME 144 - WATER
WATER CROSS CONNECTION $50.00 CROSS CONNECTION $50.00
Job ID: 15-SFR-1211 - NEW HOME W5 - WATER
WATER SDC-SYSTEM DEV CHG $1,140.00 SDC-SYSTEM DEV CHG $1,140.00
Amount Due: $7,852.05
Tender Information: Check # 3558 $7,852.05
Tender Type: CR
Totals: $7,852.05 Tender Amount: $7,852.05
Change Due: $0.00
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