1018 Main St PLRS21-0098 COAB Permit Form with Conditions - RenewedOWNER:ADDRESS:CITY:STATE:ZIP:
BISHOP JOHN HENRY 1018 MAIN ST ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
ADVANTAGE PLUMBING 880 MAYPORT RD JACKSONVILLE
BEACH FL 32240
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170996 0200 ATLANTIC BEACH SEC H
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1018 MAIN ST PLUMBING RESIDENTIAL
Plumb 10 Fixtures:
ADDITION & REMODEL -
Renewed
$2150.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT RENEWAL 455-0000-322-1000 0 $12.90
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 0 $0.00
PLUMBING FIXTURES 455-0000-322-1000 10 $70.00
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: 6/23/2021
PERMIT NUMBER
PLRS21-0098
ISSUED: 6/23/2021
EXPIRES: 4/14/2024
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $141.90
2 of 2Issued Date: 6/23/2021
PERMIT NUMBER
PLRS21-0098
ISSUED: 6/23/2021
EXPIRES: 4/14/2024
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Plumbing Permit Application ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 1 01 `p \1V\C\.,r. f PROJECT VALUE $ jO' 00
ZNEW OR REPLACEMENT INSTALLATION and/or IRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 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 L__ Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 2 Water Heater L—
Other Fixtures Water Treating System
DV1ISCELLANEOUS
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. **
DOther
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: Ackva.i,Ary Office Phone:°IOU}•2411 .c1Py S Fax
Co. Address: €7' \IV\ru R , k V_ rtCity:w ta.4.4 ,c. izSci„ State:et Zip: Z2-33
License Holder: C--Nr
C1 Tc.s t S a Certification/Registration #crc., ty2SgS'1
Notarized Signature of License Holder 4e Lz;1!
The foregoing instrument was acknowledged before—R4 this 23 day of JUN E , 20 2/ , in the State of Florida,
County of bUVf-1,
yr.Si nature of Public 2iii€€+ CHRISTIAN GILES g Notary
1.i: '• : MY COMMISSION$HH 117163
k - ;` EXPIRES.Apti113,2025
Bonded TM,NMaiyPubNcUndew11q
Personally Known OR [tOroduced Identification
Type of Identification: FL bL
Updated 10/17/18