526 Atlantic Beach Ct PLRS18-0259 PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS18-0259
800 SEMINOLE ROAD
ISSUED: 10/26/2018
T' P ATLANTIC BEACH. FL 32233 EXPIRES:4/24/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
CODE, NEC, IPIVIC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF •
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:
526 ATLANTIC BEACH CT PLUMBING RESIDENTIAL $8000.00
TYPE • BUILDING
• BD
CONSTRUCTION: NUMBER: GROUP:
ATLANTIC BEACH
1695051410 COUNTRY CLUB UNIT 02
COMPANY: ADDRESS:
NELSON PLUMBING CO. 11624-1 DAVIS CREEK ROAD EAST JACKSONVILLE FL 32256
INC.
• ADDRESS:
RUMMANS ALBERT E JR 14 TURTLE RIDGE CT RIDGEFIELD CT 06877
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAIDAMOUNT
PLUMBING
BA$EFEE 455-0000-322-1000 0 $55.00
PWMBM FIXTURES 455-0008322-1000 33 $231.00
STATE DSPR SURCHARGE 455-0008208-0700 0 $4.29
STATEDCASURCHARGE 455-0008208-0600 0 $2.86
TOTAL:$293.15
Issued Date:10/26/2018 1 of 2
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247--5826 Fax(904)247-5845 PLp S 18—o Z 5�
JOB ADDRMS: S26 kc- tw-ri c- bt/K H 14�— PERMIT# 2ES 18- 110
NEW OR REPLACEMENT INSTALLATION: Project Value S 20
TFPEOFfIriuRE QTY TYPE OFFh7URE QTY
Bathtub _� Septic Tank&Pit
Clothes Washer Showa
Dishwasher Showa Pan
Drinking Fountain Slop Sink
Floor Dram Three Compartment Sink
Floor Sink Toilet 146
Hose Bibs Urinal
Kitchen Sink ��jj�� Vacuum Breakers 5-
Laundry Tray _T_ Wates Connected Appliances I .
Lavatory ._SS�� Wata Heater
Other Fcmnes �_ Water Treating System
RE-PIPE:
TYPEOFFbauRE QTY TFPEOFFLYYM QTY
Bathtub Septic Tank&Pit
Clothes Washy Showa
Dishwasher Shbwer PanDrialcing _
Slop Sink
Floor Drain
Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kituben Sink Vacuma Breakers
Laundry Tray WaterCormecoxiAppliartoos
Lavatory Water Heater
Oth ixhaesF Water Treating System
NUSCELLANEOUS:
❑ Sewer Replacement 0 Back Flow Prevema ❑Grease Interceptor(Trap) gallons MB genres 3 sus of pts
o Lawn Sprinkler System-Number of Heads ❑ Well . **
**SIRWD Wdl Completion Form.Completed form to be submitted to the Bwlding Department for final mspecuor
❑ Other
Permit become Vold tfwork dna not cmwmce whhm asix mouth period w work z wspmded or abandoned for sa monih%I hereby cernfY tbat I Lave
dwapphi madkmwtbesamembenneafficmrert All provisions of laws and wdroaoca govanagihi5 work will be mmpliedwith whether spmc
or mt. Ilw pemutdar mt givc amhomy m violate tLe pmvisiws ofany other stern wlocal law tcgulation cmmt><dm mtbe peQwmanm ofmnstruedc
Property Owners Name I ✓t s, o oes Phone Number
Plumbing CompanyAIIFlSow Pua.48L. l / n TwC OfficePhone_ZkLj�Y981/Fax
Co.Address: .ty State_J� zip P s 6
License Holder(Print): Ow cation/Registra]ion# D 2O
rpnrtfZir eEolderZJ J/
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�miaes emerea Is.rzms Swum and subscribed before me this day of 20f1'
,• �� ,.nes,.„.� �. . ��„�.- i
Signature of Notary Public