394 SARGO RD PLRS22-0010 PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
o
CITY OF ATLANTIC BEACH PLRS22-0010
J_ v 800 SEMINOLE ROAD ISSUED: 1/20/2022
ATLANTIC BEACH. FL 32233 EXPIRES: 7/19/2022
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:
394 SARGO RD PLUMBING RESIDENTIAL PLUMBING - 9 FIXTURES $7500.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171692 0000 ROYAL PALMS UNIT
02A3.00
COMPANY: ADDRESS: CITY: STATE: ZIP:
TDG PLUMBING 4426 LOYS DR JACKSONVILLE FL 32246
OWNER: ADDRESS: CITY: STATE: ZIP:
** CONFIDENTIAL ** ** CONFIDENTIAL ** ** CONF ** XX #####
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT II`
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.
AMAMI
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 9 $63.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2 00
TOTAL:$122.00
Issued Date:1/20/2022 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
\';i PLRS22-0010
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 1/20/2022
^_�;J%-
ATLANTIC BEACH, FL 32233 EXPIRES: 7/19/2022
Issued Date:1/20/2022 2 of 2
Plumbing Permit Application **ALL INFORMATION
( - HIGHLIGHTED IN
t
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 P LIDS Z -oo i O
Phone: (904) 247-5826 Email: PERMIT#: S4 2_1 -0-023
JOB ADDRESS: 3q4 S 4-Plo 12-a . PROJECT VALUE $ -1SD0• oAD
E 1JEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 1 Septic Tank & Pit
Clothes Washer I Shower 1
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet Z
Hose Bibs Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 2 Water Heater
Other Fixtures Water Treating System
aVIISCELLANEOUS U
Sewer Replacement
['Back Flow Preventer
DLawn Sprinkler System (number of sprinkler heads)
E3rease Interceptor (Trap) gallons (Requires 3 sets of plans)
0 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: 4Ritgi Phone Number:
Plumbing Company: J1)G -1 `Ltw.birti Office Phone: go4S4S134 I Fax .5'69 - 1 8',s'8
Co. Address:
l_ 1‘4a� LL13 •O 2 City: �0.cK Suy\vi II-e State: FL- Zip: 3 Z2 410
License Holderr fi `i ' a 6 (-l'�A el State Certification/Registration # CFC- HZ---1 n 4-Z-
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this I day of 20 , 20 2i, in the State of Florida,
County of )Lv3L.(
of Florida /
OP
�.rf+'"4�. Notary Public State Signature of Notary Public
�h Aaron John htolland
1a^ My commission GG 225805
Expires 06/06/2022 [✓f Personally Known OR [ ] Produced Identification
Type of Identification:
Updated 10/17/18
•
# yR y v
r -
">
.!` . .ir F r J ,
i -
•
•
t+::;;. { +$. : . ?> <x art 1: •
•
e
•
•
t
....I... .. f. .
.. •, .. ,
�z�t rf "