1889 Beach Ave PLRS23-0038 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
EMANS CHRISTOPHER F 1651 SEMINOLE RD ATLANTIC BEACH FL 32233-5855
COMPANY:ADDRESS:CITY:STATE:ZIP:
CUSTOM PLUMBING AND
TILE 2742 SETTLEMENT DR JACKSONVILLE FL 32226
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169686 0000 NORTH ATLANTIC BCH
UNIT 2
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1889 BEACH AVE PLUMBING RESIDENTIAL 22 Fixtures $1955.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 22 $154.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.14
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.09
TOTAL: $214.23
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 3/7/2023
PERMIT NUMBER
PLRS23-0038
ISSUED: 3/7/2023
EXPIRES: 9/3/2023
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 3/7/2023
PERMIT NUMBER
PLRS23-0038
ISSUED: 3/7/2023
EXPIRES: 9/3/2023
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Plumbing Permit Application ALL INFORMATION
S l-1`:
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
Pt, 003800SeminoleRd, Atlantic Beach, FL 32233 6
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: X19 8P4 C// "rye- PROJECT VALUE $9SS, 'i"
NEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan 3
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 44-
Hose Bibs 3 Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 6 Water Heater 1
Other Fixtures Water Treating System
MISCELLANEOUS
Sewer Replacement
Back Flow Preventer
Lawn Sprinkler System (number of sprinkler heads)
E Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
Well **SJRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.**
Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.
I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances
governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions
of any other state or local law regulation construction or the performance of construction.
Owner Name: En fe/t/S Phone Number:
Plumbing Company: Cu Sk$A.PitA I n,) cli- i k l-e Office Phone: `0q"ICl/4'5R 57 Fax
Co. Address: ,.2.7 415,44-6,...4,i_ 7 City: aun State: r/ Zip:S 2ZZ6
License HolderTIUMAS ACtUakistN State Certification/Registration # C-i tp 73si
Notarized Signature of License Holder
The foregoing instrument was acknowledged b e me this 7 day of I'V arrli , 2023, in the State of Florida,
County of N,urj,l
Signature of Notary Public
VANESSA ANGERS Personally Known OR [vf Pro uced IdentificationMYCOMMISSION#HH244118
Type of Identification: FL 01- V-IZI-Y 3-7(o-37g 0zp. .? . EXPIRES:Manch 23,202e
INOs 7l uckborn Updated 10/17/18