2029 DUNA VISTA CT PLRS21-0160 r`' :' PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
LJ`i" �\ CITY OF ATLANTIC BEACH PLRS21-0160
800 SEMINOLE ROAD
ISSUED: 10/25/2021
ATLANTIC BEACH. FL 32233EXPIRES: 4/23/2022
Oro
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:
2029 DUNA VISTA CT PLUMBING RESIDENTIAL PLUMBING - 16 FIXTURES $800.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: : NUMBER: GROUP:
169506 1622 SELVA NORTE UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
COUF PLUMBING LARRY
COUF 6110-7 POWERS AVE JACKSONVILLE FL 32217
t, ,,M : OWNER: �� ADDRESS: I CITY: STATE: ZIP:
DUKES MICHAEL W 2029 DUNA VISTA CT ATLANTIC BEACH FL 32233-4534
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT If\
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 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: 10/25/2021 1 of 2
PlumbingPermit Application **ALL INFORMATION
, f,L,�r, pp
jHIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 I
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:PLRSZ 1 -OL Co(
JOB ADDRESS: O)v*41 du nc-t v.'S ti--a_ PROJECT VALUE $ gS<%G
E{NEW OR REPLACEMENT INSTALLATION and/or LidRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub d- Septic Tank& Pit
Clothes Washer ) Shower of
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3•
Hose Bibs a Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Li Water Heater I
Other Fixtures Water Treating System
❑MISCELLANEOUS
❑ Sewer Replacement L9.-
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprink :r heads
❑ Grease 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. **
❑ 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: ni;k{ cXvkt; Phone Number: "al3' --
Plumbing Company: (e,f 9I u-•14- -1 Office Phone: 41-41 Vi9-33Y4ax
Co. Address: '26 SCS 119.,-,f41 c'ovC .-U-4,,I City: d a,y State: FL Zip: 3a-,• 7
License Holder: 1..._,,,sy Ga. tate Certification/Registration # &fc v421(10
7
Notarized Signature of License Holder . __
The foregoi •• trumentt w s acknowledged before m• iC •:y �, 0�_ , 2�/in the State of Florida,
County of )lrC�Y
,., R..r�,�...•+�► Signature of Notary Public r
4, ,
V PO•- TONI G:NDLESPERGER
=MS 6(,c�
*: •x MY COMMISSION#GG 353178 [ ersonally Known OR [ ] Produced Identification
2023
°9 EXPIRES:October6,dery Type of Identification:
Fo ,,±.-_____2onded Thru NotaryPublic Undervrtiters
Updated 10/17/18