310 Plaza St PLRS22-0080 r . , PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
r. ,r _ i CITY OF ATLANTIC BEACH PLRS22-0080
-~ 800 SEMINOLE ROAD ISSUED: 6/1/2022
4'/r.si EXPIRES: 11/28/2022
ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4PM 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: I PERMIT TYPE I DESCRIPTION: I VALUE OF WORK:
310 PLAZA PLUMBING RESIDENTIAL PRIVATE PROVIDER $20000.00
PLUMBING-28 FIXTURES
TYPE OF REAL ESTATE 1BUILDING USE
ZONING: i
SUBDIVISION:
CONSTRUCTION: NUMBER: I GROUP:
169954 0000 ATLANTIC BEACH
COMPANY: I ADDRESS: i CITY: @ STATE: I ZIP:
MIKE SANVILLE PLUMBING 5627 Verna Blvd. #3 JACKSONVILLE FL 32205
INC
OWNER: I ADDRESS: fi CITY: ! STATE: I ZIP:.
MARQUES JASON M 1747 OCEAN GROVE DR ATLANTIC BEACH FL 32233
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 28 $196.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.77
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.51
TOTAL:$257.28
Issued Date:6/1/2022 1 of 2
Plumbing Permit Application **ALL INFORMATION
,; "'" HIGHLIGHTED IN
- : _ City of Atlantic Beach Building Department . R UIRED.
;-'7 1 800 Seminole Rd, Atlantic Beach, FL 32233 LG. Z'DCDc-(
c-A"'l Phone: (904) 247-5826 Email: Building-Dept@coab.us #:eal_22_--. 2&
-Q
JOB ADDRESS: '/ CS / /c ZG,, PROJECT VALUE$ g6C0 cl
❑NEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 1 Septic Tank& Pit
Clothes Washer Shower e.–/%,,
Dishwasher ( Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet L/
Hose Bibs � Urinal •
•
Kitchen Sink — Vacuum Breakers
Laundry Tray I Water Connected Appliances li
Lavatory 7 Water Heater o2
Other Fixtures — ( ater Treating System 1
El MISCELLANEOUS
E Sewer Replacement V
❑ 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
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:: 3ZSCb"J '� / /JcJ. U e 5 Phone Number:
Plumbing Company:!M'i(e_. S#'9Nv/ , I GC-3/Mice Phone: J g(ira0 if Fax WV- 3
Co. Address:.5(o7 (je/Yt/C, 4?LI&I 7 City:i 3.7 . _ State:Ft ,Zip::77Co7i�
License Holder:.��7,"C Cie S K)Akii I./ (C-- Sta ertification/Registration#'C1 r- 0 5 r6/67
Notarized Signature of License Holder �./�A� 'e�
The forego' instrument was acknowledged before me this / f on , 20, the State of Florida,
County of C)Nr
'NYSignature of Notary Public ,. --....A
-172 .:_5_: Personally Known OR [ ] Produced Identification`
TON/GiNDLESPERGER 1Type of Identification:
r :_ _ , .• t%OMMISSION#GG 353178 Updated 10/17/18
:t :;� RES:October 6,2023s
.2.;.c.,
__ -
".�PINNota
- ,., Notary Public Underwriters