1915 Creekside Ct PLRS23-0025 Permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
,s
CITY OF ATLANTIC BEACH PLRS23-0025
800 SEMINOLE ROAD
ISSUED: 2/3/2023
ATLANTIC BEACH. FL 32233 EXPIRES: 8/2/2023
MUST CALL INSPECTION • •NE LINE (904) 247-581. BY . PM FOR . INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 15TH EDITION1 OF • '
CODE, OF • OF ORDINANCES .
ALL CONDITIONS OF . . 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: DESCRIPTION: __LVALUE OF WORK:
1915 CREEKSIDE CIR PLUMBING RESIDENTIAL PLUMBING - 17 FIXTURES $14350.00
TYPE OF
ZONING: :D •
• • GROUP:
172020 1216 SELVA MARINA UNIT 12
COMPANY: ADDRESS: CITY: STATE: ZIP:
All Scale Plumbing 1518 Whitlock Ave Ste 2 Jacksonville FI 32211
• ADDRESS:
RUSSO DAVID 1915 CREEKSIDE CIR ATLANTIC BEACH FL 32233-4505
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 17 $119.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.61
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $178.61
Issued Date:2/3/2023 1 of 2
Plumbing Permit Application * ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 P1 �Op2ls
Phone: 904 247-5826 Email: Buildin -Det coab.us PERM �1
( ) // >; N
JOB ADDRESS: I�I S 6.6('k .51 ' 6 G 1 r PROJECT VALUE $ / 5�i O�
❑NEW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 1 Septic Tank & Pit
Clothes Washer l Shower �.
Dishwasher I Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs aZ Urinal
Kitchen Sink I 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 sprinkl s)
❑ 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.re
Owner Name: 00,u1, J 9 U Phone Number:
Plumbing Company: / I SG ��� li>7 dffice Phone: q3� Fax
Co. Address: /J/ O �/ 1h,��- r'i!�• (/ City: J��4*9/0��tState:/4/ Zip: �s2
License Holder: i I&A9 I Certification/Registration # (/
Notarized Signature of License Holder
The forego nstrumenwas acknowledged before a this day of , 202 the State of Florida,
County of
Signature of Notary Public .�
TONIGINDLESPERGER Personally Known OR Produced Identification
MY COMMISSION#GG 353178 Type of Identification:
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c; EXPIRES:October 6,2023
Bonded Thru Notary Public Underwriters Updated 10/17/18