301 Belvedere PLRS18-0269 ' ''• PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS18-0269
800 SEMINOLE ROAD ISSUED: 11/7/2018
ATLANTIC BEACH. FL 32233 EXPIRES: 5/6/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
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:
301 BELVEDERE ST PLUMBING RESIDENTIAL $400.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1707030272 SEASPRAY
ADDRESS:
AGT Plumbing LLC 1167 Lake Asbury Dr Green Cove Springs FL 32043
• ADDRESS:
RODENKIRCH THOMAS C 301 BELVEDERE ST ATLANTIC BEACH FL 32233-4110
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-OOOOd22-1000 0 $5500
PLUMBING FIXTURES 455-000Od22-10011 3 $2100
STATE DBPR SURCHARGE 455-0000-208-0700 0 $200
STATE DCA SURCHARGE 455-0000808-0600 0 $2.00
TOTAL:$80.00
Issued Date: 11/7/2018 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS18-0269
800 SEMINOLE ROAD ISSUED: 11/7/2018
ATLANTIC BEACH. FL 32233 EXPIRES: 5/6/2019
Issued Date: 11/7/2018 2 of 2
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: 3oI S-r �3yPERNIIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFIXTURE QTY TYPEoFPIXTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Stop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures J— Water Treating System
RE-PIPE:
TYPEoFFIXTuRE QTY TYPEoFFIXTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Thee Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tmy Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System -
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ 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 sin 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..
Property Owners Name (CoDSAIL/r('/ln Phone Number
'-Cf/QV62?'9761/
Plumbing Company """ Office Phone b
Co.Address: A,�'�' / City late/Z Zip 313
License Holder(Print): State Certification/Registration# (2fr-/S12Sf975
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Signature of Notary Public