650 BegoniaSt PLRS22-0086 Plumb Permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
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_ ' " CITY OF ATLANTIC BEACH
PLRS22-0086
800 SEMINOLE ROAD
ISSUED: 6/8/2022
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ATLANTIC BEACH. FL 32233 EXPIRES: 12/5/2022
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 I DESCRIPTION: VALUE OF WORK:
650 BEGONIA ST PLUMBING RESIDENTIAL PRIVATE PROVIDER
PLUMBING 13 FIXTURES $9500.00
TYPE OF REAL ESTATE / BUILDING"USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170921 0000 ATLANTIC BEACH SEC H
COMPANY: ' ADDRESS: CITY: STATE': ZIP:
DREW HARTMANN 4331 CEDAR RD ORANGE PARK FL 32065
PLUMBING, INC.
OWNER: ADDRESS: I CITY: STATE: ZIP:
HOLSTAR LLC 6685 BOWIE RD JACKSONVILLE FL 32219
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IIN
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 13 $91.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.19
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$150.19
Issued Date:6/8/2022 1 of 2
Plumbing Permit Application **ALL INFORMATION
j� HIGHLIGHTED IN
�►' City of Atlantic Beach Building Department GRAY IS REQUIRED.
x' _. / 800 Seminole Rd, Atlantic Beach, FL 32233 PLRS 22:008-G
Phone: (904) 247=5826 Email: Building-Dept@coab.us PERMIT ?P ig0.0.5
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JOB AD RESS:. C.O., ge o/v/P- PROJECT VALUE$ 7
EW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub / Septic Tank& Pit .
Clothes Washer ___Z_. Shower ____
Dishwasher _Z__ Shower Pan
Drinking Fountain Slop Sink -
Floor Drain -r Three Compartment Sink r 'r`
Floor Sink — Toilet 0-
Hose
Hose Bibs 2 Urinal
Kitchen Sink /I - Vacuum Breakers ---,--
Laundry Tray Water Connected Appliances
Lavatory Water Heater /-
Other Fixtures ater Treating System ..,--
CI MISCELLANEOUS
❑ Sewer Replacement
Ti 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.
g t / '� - l if Phone Number:Owner Name:i C7J---
iin Li Plumbing Company:[10/el-L)- /2/79‹. 2 /►'� /:,Office vnone:i -/- 613 --;) e,fax 2-65'/Yl
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Co.Address:11:/ C (/ vCity: / Zip:
// State Certification/ egistratio.
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License Holder.� �p7� C�z°,U!!G � ��
Notarized Signature of License Holder
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The foregoi strument wias acknowledged before me this da, • "_ 01 22 n the State of Florida,
County of 0 kick,
Signature of Notary Public 111111:1Ag-:- I
-
4"r ,'•Y'` ;; TCi I GINDLESPERGER '= sonally Known OR [ ] Produced Identification
4 =,•_, ;,; mr.t,G MISSION#GG 353176 ype of Identification:
`,'>;•c-..,;Z:• EXPIRES:October 6,2023
p,i_- ••:•°°;`O• Bonded Thru Notary Public Underwrite ' Updated 10/17/18