208 Seminole Rd. PLR22-0033 Plumbing Permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS22-0033
800 SEMINOLE ROAD ISSUED: 3/14/2022
au? ATLANTIC BEACH. FL 32233 EXPIRES: 9/10/2022
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
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CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS
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:
208 SEMINOLE RD PLUMBING RESIDENTIAL PLUMBING - ONE FIXTURE $50.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: —NUMBEIR: GROUP:
170519 0010 SALTAIR SEC 01
COMPANY: ADDRESS:
• ADDRESS:
TANG KENNETH I 208 SEMINOLE RD ATLANTIC BEACH FL 32233-4143
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
PLUMBING BASE FEE 455-INNER)d22-1000 0 $55.00
PLUMBING FIXTURES 4550000322 1000 1 $7.00
STATE DEER SURCHARGE 4550"208-07M 0 52.00
STATE DCA SURCHARGE 4550000-208-0600 0 $2.00
TOTAL:$66.00
Issued Date:3/14/2022 1 of 1
ALL
INFORMATIONPlumbin Permit Application HIGHLIGHTEDIN
City of Atlantic Beach Building Department GRAY 15 REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 PLRSZZ -00'�7j
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT M:
JOB ADDRESS: Zo8SCJ"/✓a'«`��..Y., PROJECT VALUE$'�3L• �D
❑NEW OR REPLACEMENT INSTALLATION and/or LR�E-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink _� Vacuum Breakers
LaundryTray Water Connected Appliances_
Lavatory Water Heater _
Other Fixtures Water Treating System
❑MISCELLANEOUS
❑Sewer Replacement
❑ Back Flow Preventer
Lawn Sprinkler System(number 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 kr'T[K-rN SINK 5V1'P1Y ONES, fio— WRTevt 2r•2iRc ?,MJ'
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: KEY`t 74A16, Phone Number:29W 2/(6 (D`/(o
Plumbing Company: � ne/� Office Phone: Fax
Co.Address: City: State:_Zip:
License Holder: State Certification/Registration q
Notarized Signature of License Holder
The forego! I trument wa acknowledged before me this da 20 Z In the State of Florida,
County of
ETONI GIRDLESPERGER Signature of Notary Public
MYC0`iknSS 10N 8 GG 363178EXPIRES;0,.I r62023Personally Known OR [ ] Produced Identification
eo�ara TnN Na„yPu6lwum.,w,p� Type of Identification:
UPWWJOI17128