309 Plaza PLRS23-0199 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
STEVEN AND REBECCA
GOLDWASSER REVOCABLE
TRUST
8483 STABLES RD JACKSONVILLE fl 32256
COMPANY:ADDRESS:CITY:STATE:ZIP:
DUVAL CONSTRUCTION
INC 13221 Mendenhall Pl JACKSONVILLE FL 32224
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169990 0000 ATLANTIC BEACH
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
309 PLAZA PLUMBING RESIDENTIAL MAIN HOUSE - 27 FIXTURES $6000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 27 $189.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.66
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.44
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
PLRS23-0199
ISSUED: 11/30/2023
EXPIRES: 5/28/2024
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
TOTAL: $250.10
2 of 2Issued Date: 11/30/2023
PERMIT NUMBER
PLRS23-0199
ISSUED: 11/30/2023
EXPIRES: 5/28/2024
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
PlumbingPermit Application ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department RAY IS REQUIRED.
j'': 800 Seminole Rd, Atlantic Beach, FL 32233 L C Z ---CP1
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT tt:1 650-0o2‘
JOB ADDRESS: 3o 9 V f 19714 PROJECT VALUE $ 0t`9 • (9O
El NEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 1_ Septic Tank & Pit
Clothes Washer I Shower
Dishwasher Shower Pan 3
Drinking Fountain Slop Sink
Floor Drain I Three Compartment Sink
Floor Sink Toilet 5
Hose Bibs 2- Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray L Water Connected Appliances /
Lavatory Water Heater
Other Fixtures Water Treating System i___1
MISCELLANEOUS7tiCSewerReplacement
C Back Flow Preventer
C Lawn Sprinkler System (number of sprinkler heads)
C Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
C 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.
Y
Owner Name: w/ 04012/0 Phone Number:07 -233-06(po
Plumbing Company: pl/wiz (,24f've,49O' Office Phone: g49g 8P 4A3`#ax
Co. Address: /322J 1 VwJ119 It P2.- City: Ytk,' State: fi Zip: 32279—
License
2274'
License Holder: ' - X41 iiliry Sta tification/Registration # Cg/43O02 -
j7,
Notarized Signature of License Hold• .' ZS'
The foregoing instrumentwas acknowledged before me this 3 C day of I CA/ , 202 the State of Florida,
County of A.B iVO. \
1
Signature of Notary Public ":41,44/
A,
Personally Known R/ [ ' oduced Identification
Y` ':. TONI GINDLESPERGER Type of Identificatio
MY COMMISSION#HH 407122 1
I+ Updated 10/17/18
4"- :°' EXPIRES:October 6,2027 —
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