1945 Beach Ave PLPP23-0018 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
OLD GROVE MANOR LAND
TRUST ONE INDEPENDENT DR STE 1200 JACKSONVILLE FL 32202
COMPANY:ADDRESS:CITY:STATE:ZIP:
NELSON PLUMBING CO.
INC.11624 -1 DAVIS CREEK ROAD EAST JACKSONVILLE FL 32256
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169694 0000 NORTH ATLANTIC BCH
UNIT 2
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1945 BEACH AVE
PLUMBING COMMERCIAL OR
MULTIFAMILY DETAILS PER
BUILDING PLAN
REMODEL - 24 PLUMBING
FIXTURES $20000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 24 $168.00
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: 7/26/2023
PERMIT NUMBER
PLPP23-0018
ISSUED: 7/26/2023
EXPIRES: 1/22/2024
PLUMBING COMMERCIAL OR
MULTIFAMILY DETAILS PER
BUILDING PLAN PERMIT
CITY OF ATLANTIC BEACH
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.35
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.23
TOTAL: $228.58
2 of 2Issued Date: 7/26/2023
PERMIT NUMBER
PLPP23-0018
ISSUED: 7/26/2023
EXPIRES: 1/22/2024
PLUMBING COMMERCIAL OR
MULTIFAMILY DETAILS PER
BUILDING PLAN PERMIT
CITY OF ATLANTIC BEACH
Plumbing Permit Application
ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
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Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: ` PP 2:5-00(
JOB ADDRESS: l.14? 1. ° " " A-06)6 PROJECT VALUE $ Z 0/ OCC
LIJEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank & Pit
Clothes Washer I__ Shower 3
Dishwasher I Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs q Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Heater
Other Fixtures ter Treating System
MISCELLANEOUS
7---)
Sewer Replacement
7\/
Back Flow Preventer
Lawn Sprinkler System (number of sprinkler heads)
Q,rease 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.
n
Owner Name: geA)•Tr /1/41e. (SO#J Phone Number: get Z62'•Y8$Y
Plumbing Company: 'SOA) R,41)141/46 agPfpffice Phone: fay.2Z.I ibp(ax
Co. Address: I1624-1 D Vd% Ot€ l. to E City:463.-hr State:ja.Zip: 32
License Holder: Se_n7 ` 1 .0#j Sta •' C rti' ca ion/Registration # 02,4379
Notarized Signature of License Holder
AI F
The foregoing • trument was acknowledged before me this "1-) day of ' 200 3, in the State of Florida,
County of LA, Cl-
itiki ,
Signa re of Notary Public L Ir'J BfCr?/r o
4.Yr....-
46.-Abr'-'"
4"1"1"11".
ode. LISA a'ASS
Notary Public-State of Florida Personally Known OR [ ] Produced Identification
Commission 9 GG 910213
My Comm.Expires Nov 16.2023 Type of Identification:
f ... •...• . . • Nati.-PelelMaillubvAL
Updated 10/17/18