1373 BEACH AVE PLRS22-0032 - 0,-.A' PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
111
r t i CITY OF ATLANTIC BEACH PLRS22-0032
8007.
ISSUED: 3/14/2022
SEMINOLE ROAD
.4°i;19~ ATLANTIC BEACH. FL 32233 EXPIRES: 9/10/2022
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:
1373 BEACH AVE PLUMBING RESIDENTIAL PLUMBING - 13 FIXTURES $10000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170300 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
TDG PLUMBING 4426 LOYS DR JACKSONVILLE FL 32246
OWNER: ADDRESS: CITY: STATE: ZIP:
WME FAMILY HOLDINGS 1393 BEACH AVE ATLANTIC BEACH FL 32233
LLC
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 PAID AMOUNT
I PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 13 $91.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.19
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $150.19
Issued Date:3/14/2022 1 of 2
Y ' Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 P L RS Z Z- 03c
` Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: R cS-17.' 0931
JOB ADDRESS: IV (Jct, IA\l'e-- PROJECT VALUE$ /CJ/ 00p
❑NEW OR REPLACEMENT INSTALLATION and/or ❑RE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank& Pit
Clothes Washer li Shower 1
Dishwasher _I_ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet _
Hose Bibs -2--- Urinal
Kitchen Sink _'L_ Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory _ Water Heater
Other Fixtures \ Water Treating System
\),CI MISCELLANEOUS
Sewer Replacement
Back Flow Preventer
Lawn Sprinkler System f umbe of sprinkler 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: Phone Number:
Plumbing Company:MUD ftt,,b;41i Office Phone: Ss--) 41., Fax6'tot-4$77
Co. Address: 44{ .L Lo' ( 1‘1-- City:S4 State:rL Zip: 31...Z-4 (0
License Holdery r3('t J•"S Q (0144%1State Certification/Registration# CFC-(41 7CO-
Notarized Signature of License Holder
The foregoiir i strument wai acknowledged before me this I Y f 1 1.1`. 2C2 in the State of Florida,
County of 0 1tQ ,
i
N .
'gnature of Notary Public '
40.S0YP'' TOM GINDLESPERGER
. a * MY COMMISSION#GG 35 317 Personally Known OR [ I Produced Identification
EXPIRES:October 6> 3
°' � Q:• `ype of Identification: I
-f EF:,• Bonded Thru Notary Public Underwrfters
i3OOwF
Updated 10/17/18