376 10th Street PLRS22-0127 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
LUCERO MICHAEL 11644 SHERBORNE CIR S JACKSONVILLE FL 32225
COMPANY:ADDRESS:CITY:STATE:ZIP:
Casa - Contracting PO Box 56726 Jacksonville Fl 32241
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170053 0000 ATLANTIC BEACH
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
376 10TH ST PLUMBING RESIDENTIAL PLUMBING - 26 FIXTURES $2000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 26 $182.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.56
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.37
TOTAL: $242.93
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 9/2/2022
PERMIT NUMBER
PLRS22-0127
ISSUED: 9/2/2022
EXPIRES: 3/1/2023
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 9/2/2022
PERMIT NUMBER
PLRS22-0127
ISSUED: 9/2/2022
EXPIRES: 3/1/2023
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
PLRS22-0127
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $242.93
PLRS22-0127 Address: 376 10TH ST APN: 170053 0000 $242.93
PLUMBING $237.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 26 $182.00
STATE SURCHARGES $5.93
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.56
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.37
TOTAL FEES PAID BY RECEIPT: R20778 $242.93
Printed: Friday, September 2, 2022 2:40 PM
Date Paid: Friday, September 02, 2022
Paid By: Casa - Contracting
Pay Method: CREDIT CARD 717766068
1 of 1
Cashier: TG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R20778