583 Royal Palms Dr PLRS22-0187 Outside Shower 4 � �,�,= PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
r . : sir..
_ CITY OF ATLANTIC BEACH PLRS22-0187
ISSUED: 12/19/2022
800 SEMINOLE ROAD
'�i,a. : EXPIRES: 6/17/2023
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 maybe 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: j VALUE OF WORK:
583 ROYAL PALMS DR PLUMBING RESIDENTIAL . OUTSIDE SHOWER $1000.00
TYPE OF I REAL ESTATE I BUILDING USE
ZONING: I SUBDIVISION:
CONSTRUCTION: NUMBER: i GROUP:
171285 0000 I _ -
ROYAL PALMS UNIT 02
COMPANY: ADDRESS: CITY: I STATE: ZIP:
JACKSONVILLE
JOHN MOON PLUMBING • 1103 PALM CIR FL 32250
BEACH
OWNER: ADDRESS: 1 CITY: STATE: j ZIP:
GALLAGHER GLENN T 583 ROYAL PALMS DR ATLANTIC BEACH :; FL 32233-3942
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:12/19/2022 1 of 2
T. Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
1 ; S A-i, City of Atlantic Beach Building Department GRAY IS REQUIRED.
'V J4 800 Seminole Rd, Atlantic Beach, FL 32233 �^ Q
r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:P RSZZ-3i ,1
JOB ADDRESS: 583 Royal Palm Dr.Atlantic Beach 32233 PROJECT VALUE $1000.00
: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
❑VIISCELLANEOUS
❑Sewer Replacement
❑Back Flow Preventer
❑Lawn Sprinkler System (number of sprinkler heads)
❑Grease Interceptor (Trap) gallons (Requires 3 sets of plans) -
E I Well **SJRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection. **
DOther 1 Outside Shower Valve. Please attach to Permit#-RES-22-0310
miimimmimmimmoNmmimmmNmmmmi
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:Tri-H Phone Number: 904-509-2528
Plumbing Company: John R Moon Plumbing Company Office Phone: 904-249-2785 Fax
Co. Address: 2602 West End Street City: Atlantic State: FL Zip: 32233
License Holder: John R Moon, JR State Certification/Registration # CFC019200
Notarized Signature of License Holder / tit g/W
The fore fstrument was acknowledged before me this 19 . • of�@ n , 202_8n the State of Florida,
County of- L `f Com—
'
Signature of Notary Public
ii. TONT GINDLESPERGER %
,11ii• •::_ MYCOMMISSION#GG383178
t,;;:v••. ,g EXPIRES:October 6.2023 [ ] Personally Known OR [ ] Produced Identification
d ``'' Type of Identification:
`! ��D F�OQ�� Bonded•Thru NotaryPublic Underv�mters yp � l
:1........
• Updated 10/17/18