1600 Selva Marina Dr PLRS23-0156 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
ATLANTIC BEACH
COUNTRY CLUB INC 1600 SELVA MARINA DR ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
ELITE PLUMBING LLC 85 DEBERRY AVE APT 3081 ORANGE PARK FL 32073
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
172000 0010 SELVA MARINA UNIT 05
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1600 SELVA MARINA DR PLUMBING RESIDENTIAL PLUMBING - 9 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 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
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: 11/30/2023
PERMIT NUMBER
PLRS23-0156
ISSUED: 11/30/2023
EXPIRES: 5/28/2024
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 11/30/2023
PERMIT NUMBER
PLRS23-0156
ISSUED: 11/30/2023
EXPIRES: 5/28/2024
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Plumbing Permit Application
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
••ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
Phone: (904) 247-5826 Email:Building. mpt@coab.us PERMIT N:
JOB ADDRESS: 0 PROJECT VALUE $-AL-UD-U——-——---
EW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY
Bathtub
Clothes Washer
Dishwasher
Drinking Fountain
Floor Drain
Floor Sink
Hose Bibs
Kitchen Sink
Laundry Tray
Lavatory
Other Fixtures
OMISCELLANEOUS
Sewer Replacement
CJ Back Flow Preventer
TYPE OF FIXTURE
Septic Tank & Pit
Shower
Shower Pan
Slop Sink
QTY
Three Compartment Sink
Toilet
Urinal
Vacuum Breakers
Water Connected Appliances
Water Heater
Water Treating System
Lawn Sprinkler System (number of sprinkler heads)
CJ Grease Interceptor (Trap)gallons (Requires 1 set of digital 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:
Plumbing Company:
Co. Address:
License Holder:6
Phone Number:
Office
City: ( Zip: 3 Il
ate Certification/Registration
Notarized Signature of License Holder
The foregoing strum t was acknowledged before me this 2day of , 200,in the State of Florida,
County of
CORNELIUS R. BREWSTER IV
Notary Public. State of Florida
Commission* HH 369029
My comm. expires March 5.2027
Signature of Notary Public
[ I Personally Known OR [odyced Identificatio
Type of Identification:
Updated 10/11/23
PLRS23-0156