647 Beach Ave PLRS22-0188 Re-Pipe -sv-1-#4, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS22-0188
Raz CITY OF ATLANTIC BEACH
ISSUED: 12/20/2022
800 SEMINOLE ROAD EXPIRES: 6/18/2023
ATLANTIC BEACH. FL 32233
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: I PERMIT TYPE: I DESCRIPTION: VALUE OF WORK:
647 BEACH AVE PLUMBING RESIDENTIAL PLUMBING - RE-PIPE $4000.00
TYPE OF REAL ESTATE I BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170117 0000 ATLANTIC BEACH
COMPANY: I ADDRESS: I. CITY: I, STATE: ZIP
TDG PLUMBING 4426 LOYS DR JACKSONVILLE FL 32246
OWNER: I ADDRESS: CITY: STATE: ZIP:
NOVEMBER JAMES 647 BEACH AVE ATLANTIC BEACH ' FL 32233-5325
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 1 $7.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$66.00
Issued Date: 12/20/2022 1 of 2
A�{ -r. Plumbing Permit Application **ALL INFORMATION
1: HIGHLIGHTED IN
;rr, ":- i City of Atlantic Beach Building Department GRAY IS REQUIRED. .
'' - 800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 1LR.SZZ OIN
JOB ADDRESS:, (4r a C;V\ t::)U Q. PROJECT VALUE$ C-11 0 0 0.0 'D
❑NEW OR REPLACEMENT INSTALLATION and/or ORE-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
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS
❑ Sewer Replacement
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler heads)
CI 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 Pei r r*sivk L a e p; (I�,.,
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 Ihave 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: ,p... AOt,e.,r C..N Phone Number:
Plumbing Company:7170 (a �1.._k.IZ' 1 Office Phone: , : FaxiSVH s 8
:
Co. Address: "►ki l.... I-01 S PO- City:; .3"-NState:
1-n 'FL Zip: ‘ID.Z Li 4'
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License Holder:-1 b ^e. State Certification/Registration#ICFC-Na-.?DC2
Notarized Signature of License Holder - _.
The foreg in strument wa acknowledged before me thisZ a • e C` , 207 [n the State of Florida,
County of� U V
0
1. t :;i ., TONI GINDLESPERGER
1'7 AGA °'- MY COMMISSION#GG 353178
*• Tri, *= Signature of Notary Public � �
..�;,7• EXPIRES:October 8,2023 _—
..,.....Q.'.
•:FBFt;;°•••
Bonded Thru Notary Public Underwriters
] Personally Known OR [ ] Produced Identification
Type of Identification:
Updated 10/17/18