1722 SEA OATS DR PLRS23-0031 PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
JS P„
CITY OF ATLANTIC BEACH PLR523-0031
5 ISSUED: 2/22/2023
s 800 SEMINOLE ROAD
,� EXPIRES: 8/21/2023
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:
1722 SEA OATS DR PLUMBING RESIDENTIAL PLUMBING - 10 FIXTURES $1800.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0436 SELVA MARINA UNIT 08
COMPANY: ADDRESS: CITY: STATE: ZIP:
PAT'S PLUMBING
COMPANY LLC 5947 PICKETVILLE RD JACKSONVILLE FL 32254
OWNER: ADDRESS: CITY: STATE: ZIP:
1722 SEA OATS REALTY ONE INDEPENDENT DR STE 3120 JACKSONVILLE FL 32202
HOLDINGS LAND TRUST
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 10 $70.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$129.00
Issued Date: 2/22/2023 1 of 2
r1y:L`Iri,,
Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
J "'' City of Atlantic Beach Building Department
OEGRAY IS REQUIRED.
Li
P
800 Seminole Rd, Atlantic Beach, FL 32233 LR S Z3-503
'��'`,), Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 2 3--0 O/J
JOB ADDRESS: /7 -7-4 Ste- 0797& PROJECT VALUE $ ( 8 0
❑NEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 2 Septic Tank& Pit
Clothes Washer Shower /
Dishwasher / Shower Pan /
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 2.
Hose Bibs Urinal
Kitchen Sink _,/_ Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 2 Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS `O
Sewer Replacement
Back Flow Preventer
Li Lawn Sprinkler System (number of sprinkler eads)
-, 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: Phone Number:
Plumbing Company: if/9—%/S //if Go Office Phone: 3/4-- /t Y/ Fax
Co. Address: s5'-/7 P/c_ !- 1/`Q-- City: "-KO( State:/ / Zip: __?2if
License Holder: tP[2c- ( Q el QL- AO r\ State Certification/Registration#
Notarized Signature of License Holder .i�, Z424.
The foregoing-ix s rument was acknowledged before me this ZZ da • —€ r) , 202- n the State of Florida,
County of ___) 0\/' ,_)\ CY'
i
C / , L
Signature of Notary Public •
4`Y"ve,.>, TONI GINDLESPERGER
r' �rMYCO,iMISSION#GG353178 [ ] Personally Known OR [ I Produced Identification
l. .rte;` EXPIRES:October6,2023 Type of Identification: (�
'. q•
' Bonded Thru Notary Public Underwriters
Updated 10/17/18