61 Dudley Street PLRS24-0014 ...A, , PLUMBING RESIDENTIAL PERMIT
%'tCPERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS24-0014
800 SEMINOLE ROAD ISSUED: 1/23/2024
�`''i1r V ATLANTIC BEACH. FL 32233 EXPIRES: 7/21/2024
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:
61 DUDLEY ST PLUMBING RESIDENTIAL PRIVATE PROVIDER $12000.00
PLUMBING - 17 FIXTURES
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172081 0010 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
STEWART PLUMBING
CONTRACTING INC 5457 Hickson Rd Jacksonville FL 32207
OWNER: ADDRESS: CITY: STATE: ZIP:
OUR FAMILY 2240 MAYPORT RD STE 7 JACKSONVILLE FL 32233
INVESTMENTS INC
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
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55 00
PLUMBING FIXTURES 455-0000-322-1000 17 $119.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.61
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 1/23/2024 1 of 2
- %'t ''",,J, PLUMBING RESIDENTIAL PERMIT
'f ) PERMITNUMBER
4' i1
s CITY OF ATLANTIC BEACH PLRS24-0014
15 Z ISSUED: 1/23/2024
'�!.Jii �� 800 SEMINOLE ROAD EXPIRES: 7/21/2024
ATLANTIC BEACH. FL 32233
TOTAL:$178.61
Issued Date: 1/23/2024 2 of 2
rir /,, Plumbing Permit Application **ALL INFORMATION
/ HIGHLIGHTED IN
i'' City of Atlantic Beach Building Department GRAY IS REQUIRED.
i 800 Seminole Rd, Atlantic Beach, FL 32233 PL._ RS 2 4 - ()Of
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: PP/22.'000 3
JOB ADDRESS: lQ / DVdl e y S1- PROJECT VALUE $ /2./ OOO. 00
L21VEW OR REPLACEMENT INSTALLATION and/or ERE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 2- Septic Tank & Pit
Clothes Washer / Shower /
Dishwasher / Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet _
Hose Bibs Z Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory L Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS
❑ Sewer Replacement \ I
,
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler heads)'
❑ 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: G 0 1 a Ke_\( �lJsivyrn M e S Phone Number: /0 *( gl( 79 /Q
Plumbing Company: .S+twgr4 POI wrl f, PIC- Office Phone: got/207 L/309 Fax
Co. Address: 5-114.7 /�,CkSon X8 City: �x State: F.- Zip: 32-zb7
License Holder: ,fie-r f y 8 )a ( State Certification/Registration #GFC l''28$06
Notarized Signature of License Holder
The foregoi rument rnras acknowledged b re me this Z da, o 0,1\ , 212 in the State of Florida,
County of ,-uc,,_
II /
Signature of Notary Public ��
.. TONI GINDLESPERGER f—Personally Known OR [ ] Produced Identification
1'4,---....,i .::. ;, MY COMMISSION#HH407122 Type of Identification:
•;- EXPIRES:October 6,2027 ,
Updated 10/11/23