149 Beach Ave PLRS23-0011 Permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS23-0011
800 SEMINOLE ROAD ISSUED: 1/17/2023
j ATLANTIC BEACH. FL 32233 EXPIRES: 7/16/2023
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT • 1 OF • '
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: DESCR-IPTICI-N: -- ---- -VALUE-OF-WORK:
149 BEACH AVE PLUMBING RESIDENTIAL PLUMBING - 4 FIXTURES $1500.00
TYPE OF
• • GROUP:
170214 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
TURNER PLUMBING CO. 1903 HENDRICKS AVE JACKSONVILLE FL 32207
• ADDRESS:
SSR FAMILY LTD ET AL 3300 PHILIPS HWY JACKSONVILLE FL 32207
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 • . •
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 4 $28.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 10 1 $2.00
TOTAL: $87.00
Issued Date: 1/17/2023 1 of 2
ALL
Plumbing Permit Application **HIGHLI HIGHLIGHTED
IN HIGHLIGHTED IN
l
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 pp
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: ` LR!S
JOB ADDRESS: 141 '9'e✓> C�'1"k- A')c---- PROJECT VALUE $ 1 5"a b
NEW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer Shower V- (JK
Dishwasher Shower Pan Y
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
Li Sewer Replacement
❑ 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.
Owner Name: ��� ( '-t—� Phone Number:
Plumbing Company � '-�f^-�✓ '�✓t��� �—. Office Phone: Cto 1 -19(o -,7044ax
Co. Address: ! '� � V5 �J� . City: .0 6L, State: V'( Zip: 31,7,0-1
License Holder: OD , l LA_ State Certification/Registration # CFS 0 Z' 114
Notarized Signature of License Holder Z3�1' `) , J
The forego' instrument s acknowledged before me this day of , 20Z-_ in the State of Florida,
County of
R Signature of Notary Public
X53178
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a irAX?q'• TONT GINDLESPERGE f Identification: l >
MY COMMISSION#GG 353178
Updated 10/17/18
EXPIRES:October 6,2023
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•%;cOF FV� Bonded Thru Notary Public Underwriters