159 11th St PLRS23-0027 ���''% PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
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r s� CITY OF ATLANTIC BEACH PLRS23-0027
}-'. 800 SEMINOLE ROAD ISSUED: 2/14/2023
.0;iiEXPIRES: 8/13/2023
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: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
159 11TH ST PLUMBING RESIDENTIAL Remodel w 2 fixtures $2000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170274 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
STEEG PLUMBING 1601 MAIN STREET ATLANTIC BEACH FL 32233
COMPANY INC
OWNER: ADDRESS: CITY: STATE: ZIP:
KELLY JOHN L ET AL 159 11th Street Atlantic Beach Fl 32233
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
I PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 2 $14.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$73.00
Issued Date:2/14/2023 1 of 2
Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
I:
J 800 Seminole Rd, Atlantic Beach, FL 32233 Pt-P---C23—cz517
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
g23_ a[b2_
JOB ADDRESS: /CI Pt PROJECT VALUE $ Z'&W I
INEW OR REPLACEMENT INSTALLATION and/or ❑RE-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 _l
Other Fixtures Water Treating System
❑MISCELLANEOUS
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: I r\ jG )1 Phone Number:
Plumbing Company: 5/r-� C/h•tioi �, Office Phone: 7�/q // Fax
Co. Address: /( j2 rPic).l h J J City: ASL- A1) State1 / Zip: ,ZZ-)Y
License Holder: —JYKt State Certification/Registration # N,fGv37nr6
Notarized Signature of License Holder 1/1/h9
,All,
The foregoing instrument was acknowledged b fore me this ILi day of �>°aY)CL
'y , 20Z3, in the State of Florida,
County of DUvOLA
Signature of Notary Public --<---'<-
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;;�.••�`"4t;•• VANESSA ANGERS
*: 1*: MY COMMISSION#HH 244118 [ ] Personally Known OR [4/Produced Identification
"4.'' �' EXPIRES:March 23,2026 Type of Identification: 0 DL c320 -9SZ-S"- -'-47 -O
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Updated 10/17/18