1852 Sea Oats Drive PLRS23-0088 S' ''\` PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
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'. -!,,
r -. PLRS23-0088
J CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 5/18/2023
�`'.rns) ATLANTIC BEACH. FL 32233 EXPIRES: 11/14/2023
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:
1852 SEA OATS DR PLUMBING RESIDENTIAL PLUMBING - 20 FIXTURES $20000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0572 SELVA MARINA UNIT 09
COMPANY: , ADDRESS: CITY: STATE: , ZIP:
KDS VENTURES LLC 27184 Murrhee Rd. Hilliard FL 32046
OWNER: ADDRESS: CITY: STATE: ZIP:
GOODRICH THOMAS 1852 SEA OATS DR ATLANTIC BEACH FL 32233
WINSTON IV
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 ir
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 20 $140.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.93
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $199.93
Issued Date: 5/18/2023 1 of 2
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PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
\`� PLRS23-0088
CITY OF ATLANTIC BEACH
V 800 SEMINOLE ROAD ISSUED: 5/18/2023 i
`t J:o %• ATLANTIC BEACH. FL 32233 EXPIRES: 11/14/2023 i
Issued Date:5/18/2023 2 of 2
yLam,, Plumbing Permit Application **ALL INFORMATION
: ��
`l, City of Atlantic Beach Building Department HIGHLIGHTED IN
GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 PL-R5 Z.-008 8
.""� ~ Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: •'il'ES,,,2 3 -Dv ..7
JOB ADDRESS: /t -Z S.---1/? 1)4-7 r PROJECT VALUE $ �i VUU
❑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 ___Z_ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink ` / Toilet
Hose Bibs 7 Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory II Water Heater 2-
Other
Other Fixtures / Water Treating System
❑MISCELLANEOUS (
LI Sewer Replacement v
Z
E 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: Ha/7-i 5---v/j/, Phone Number:
Plumbing Company: / ) . ven 7--z,te- - Office Phone: gv-7-k26- ,)__13ix
Co. Address: c7741 /9741/7/1.E--/ / 2 City: r7'//,,1/ " State: 1/Zip: 27.._P V4
License Holder: !�y,a ��/` P State Certification/Registration#6.rG/y.c223 ,e
Notarized Signature of License Holder �J <
The foregoi ' trument as acknowledged before me this ISday of • 20 the State of Florida,
County of Jl?\rR-
L11(
Signature of Notary Public2Q-
lr^`!?"'. TONT GINCLESPERGER
pl c• .: MY COMMISSION#GG 353178 [ ] Personally Known OR [ ] Produced Identification
Z;-. rya b•,' EXPIRES:October 6,2023
;±( ••9FfI? Banded ThruNo'aryPublcUnderwriters Type of Identification: .
Updated 10/17/18