1846 Seminole Road PLRS22-0148 Permit '11 PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
n CITY OF ATLANTIC BEACH PLRS22-0148
800 SEMINOLE ROAD ISSUED: 30/3/2022
a o ATLANTIC BEACH. FL 32233 EXPIRES:4/1/2023
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 entitles such as water management districts,state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1846 SEMINOLE RD PLUMBING RESIDENTIAL SHOWER PAN $1100.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0514 SELVA MARINA UNIT 09
COMPANY: ADDRESS:
STYLES SMITH PLUMBING, 1537 PENMAN RD SUITE A JACKSONVILLE FL 32250
INC BEACH
• ADDRESS:
POPP MARK A 1846 SEMINOLE RD ATLANTIC BEACH FL 32233-5916
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IP
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 455-0000-32b1000 0 $55.00
PLUMBING FI%TURES 455-OOOOd221000 1 $700
STATE DBPR SURCHARGE 1 4550000-208-0700 0 $200
STATE DCA SURCHARGE 455-0000-2080600 0 $300
TOTAL:$66.00
Issued Date:10/3/2022 1 of 2
INFORMATIONPlumbin Permit Application HIGHLIGHTEDIN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 #7 a
Phone: (904) 247-5826 Email: Building-Dept@ccab.us PERMIT If:1 22- bI 4 C
JOB ADDRESS: ]i5q6 �eM r/�oIC Id- PROJECTVALUES�Ii/00•en
igNEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE CITY
Bathtub Septic Tank&Pit
Clothes Washer Shower _
Dishwasher Shower Pan —AV-1
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
Li Sewer Replacement
❑ Back Flow Preventer
❑ Lawn Sprinkler System(number of sprinkler heads)
❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
o Well **SIRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection."*
Other 5>7awef V_IVe r
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: I1W_k SO nn Phone Number: x104 32/3 -I3f'ia
r-r
Plumbing Company:,C2MO5 SMr I7/un/n'9 .t/Y6.Office Phone: q04-81 — fW Fax
Co.Address: 15_,37 PeAMM rd. city: 7wc 5eA17n state:E1__zip: 321S6
License Holder: S±gI e S Sm�JH State Certification/Registration III GFL IN,t Zlq)q
Notarized Signature of License Holder /Yc 7
The foregoi ' trument wps acknowledged before me this day of 20z Wythe State of Florida,
County of ��1 �V c1�
^`.! TOM GINDLESPERGER ignature of Notary Public
ii �J\ /
, Vp. �` MY COMMISSION#GG 353176
EXPIRES:October 6.2023 [,�'�rsonaily Known OR [ ] Produced Identification
emdedshm Nxa6Nbftunh*exrr- Type of Identification: