774 AQUATIC PLRS23-0033 PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS23-0033
CITY OF ATLANTIC BEACH
5.)
800 SEMINOLE ROAD ISSUED: 2/22/2023
�:2 s
Ji311) ' ATLANTIC BEACH. FL 32233 EXPIRES: 8/21/2023
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:
774 AQUATIC DR PLUMBING RESIDENTIAL PLUMBING REPIPE 9 $3000.00
FIXTURES
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171818 5258 AQUATIC GARDENS
COMPANY: ADDRESS: CITY: STATE: ZIP:
STEEG PLUMBING 1601 MAIN STREET ATLANTIC BEACH FL 32233
COMPANY INC
OWNER: ADDRESS: CITY: STATE: ZIP:
LEBOUTON MARDEN 774 AQUATIC DR ATLANTIC BEACH FL 32233-3826
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 9 $63.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $122.00
Issued Date:2/22/2023 1 of 2
Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
-on yr Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: I�LRSZ 3-OO?
JOB ADDRESS: 77 /�G' h - PROJECT VALUE$
El NEW OR REPLACEMENT INSTALLATION and/or J,pRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Z 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 /1, Water Heater �—
Other Fixturesi ) Water Treating System
5
❑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. L �1
Owner Name: /..G &( )- Phone Number: 39‘.
Plumbing Company: 5�-1 / $J i (Fyl_ Office Phone: 79--5/91 Fax
Co. Address: /(pol i01i J7 City: AI ef541-1 Statei/ Zip:.3/ _33
License Holder: j1 t 5I State Certification/Registration# rd371 g.4
Notarized Signature of License Holder
The foregoing instrument was acknowledged fore me his ZdayG _ , 201 the State of Florida,
County of UV'
Signature of Notary Public Orb
,,0! TONI I TONI G!NDLESPERGER 1110 f't : : MY COMMiSSION#GG 353178 Personally Known OR [ ] Produced Identification
;,�Z,T ;r EXPIRES:October 6,2023° Type of Identification:
t,, Sondzd Thru Notary Public Underwriters
Updated 10/17/18