1071 Atlantic Blvd Keller Williams PLPP22-0001 16 fixtures permitOWNER:ADDRESS:CITY:STATE:ZIP:
1071 ATLANTIC JAX
OWNER LLC 4923 CYPRESS ST W TAMPA FL 33607
COMPANY:ADDRESS:CITY:STATE:ZIP:
Elite Plumbing Contractors
LLC 54646 Wildlife Way Callahan FL 32011
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
177411 0040 SECTION LAND
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1071 ATLANTIC BLVD
PLUMBING COMMERCIAL OR
MULTIFAMILY DETAILS PER
BUILDING PLAN
16 Plumbing Fixtures:
INTERIOR BUILDOUT -
KELLER WILLIAMS
$30000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 0 $0.00
PLUMBING FIXTURES 455-0000-322-1000 16 $112.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 1/27/2022
PERMIT NUMBER
PLPP22-0001
ISSUED: 1/27/2022
EXPIRES: 7/27/2022
PLUMBING COMMERCIAL OR
MULTIFAMILY DETAILS PER
BUILDING PLAN PERMIT
CITY OF ATLANTIC BEACH
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.51
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $171.51
2 of 2Issued Date: 1/27/2022
PERMIT NUMBER
PLPP22-0001
ISSUED: 1/27/2022
EXPIRES: 7/27/2022
PLUMBING COMMERCIAL OR
MULTIFAMILY DETAILS PER
BUILDING PLAN PERMIT
CITY OF ATLANTIC BEACH
.•ALL INFORMATIONPlumbing Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 LLCPhone: (904) 247-5826 Email:PERMIT
JOB ADDRESS:PROJECT VALUE $
OR REPLACEMENT INSTALLATION and/or ChE-PlPE
TYPE OF FIXTURE QTY
Bathtub
Clothes Washer
Dishwasher
Drinking Fountain
Floor Drain
Floor Sink
Hose Bibs
Kitchen Sink
Laundry Tray
Lavatory
Other Fixtures
DvUSCELLANEOUS
ÜSewer Replacement
DBack Flow Preventer
TYPE OF FIXTURE
Septic Tank & Pit
Shower
Shower Pan
Slop Sink
QTY
Three Compartment Sink
Toilet
Urinal
Vacuum Breakers
Water Connected Appliances
Water Heater
Water Treating System
Lawn Sprinkler System (number of sprinkler heads)
03rease Interceptor (Trap)gallons (Requires 3 sets of plans)
Well SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
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 regulat•onstruction or the performance of construction.
Phone Number:-50tOwner Name:
Plumbing Company:
Co. Address:
License Holder:
bOiO\ b)
e
Notarized Signature of License Holder
Office Phone:(Jay q 070 Fax
City:Zip: s 01
State Certification/Registration # CGI-Il-B Oq 3
The foregoing instrument was acknowledged before me this day of 20_@@in the State of Florida,
County of
JENNELL MILTON
MY COMMISSION HH 139161
EXPIRES: October 6, 2025
BooöedTYu
Signature of Notary Publi
Personally Known OR [ J duced Identification
Type of Identification:
Updated 10/17/18
PLPP22-0001
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $171.51
PLPP22-0001 Address: 1071 ATLANTIC BLVD APN: 177411 0040 $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: R18611 $171.51
Printed: Thursday, January 27, 2022 9:59 AM
Date Paid: Thursday, January 27, 2022
Paid By: ELITE PLUMBING LLC
Pay Method: CREDIT CARD 579576723
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R18611