1673 ATLANTIC BEACH DR - PLUMBING • vir,, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
p. A CITY OF ATLANTIC BEACH PLRS18-0272
lk `� 800 SEMINOLE ROAD ISSUED: 11/16/2018
41mA 1 EXPIRES: 5/15/2019
ATLANTIC BEACH. FL 32233
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:
1673 ATLANTIC BEACH DR PLUMBING RESIDENTIAL New Install $8000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169505 1360 ATLANTIC BEACH
COUNTRY CLUB UNIT02
COMPANY: ADDRESS: CITY: STATE: ZIP:
NELSON PLUMBING CO. 11624 -1 DAVIS CREEK ROAD EAST JACKSONVILLE FL 32256
INC.
OWNER: ADDRESS: CITY: STATE: ZIP:
LAURA COLEY
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 455-0000-322-1000 0 $55.00
PLUMR,t,i FIXT,IR,c <rr-n(lnn Y' 1 MO5175.001
rSTATE IAPi1 aUNCttARGI M� .sr 0700 Q + _. `,.)-i 4
I STATE OCA!URO4ARGE '155-00�30B-f�00 0 $2.30
TOTAL:$235 75j
issued[latr 11,'1:$F,fl1P , ,f
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 PLVS(E_6Z.7z
, Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: ( C0—I 3 AT LP w T%L g tr A c.a-( 1)rt.. PERMIT# (LES l e-03 .
NEW OR REPLACEMENT INSTALLATION: Project Values gj 000
TYPE OF FiXTURE - QTY TYPE OF FIXTURE QTY
Bathtub 3 Septic Tank&Pit
Clothes Washer ____L_ Shower _L._
Dishwasher _1_ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 4 0
Hose Bibs 2. Urinal
Kitchen Sink _1_ Vacuum Breakers Z
Laimdry Tray Water Connected Appliances 1
Lavatory = Water Heater •
Other Fixtures _L_ Water Treating System _1_
RE-PIPE:
TYPE OF FIXTURE QTY TYPE OFF1XFURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Slower Pan
Drinking Fountain Slop 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 Water Treating System
MISCELLANEOUS:
o Sewer Replacement 0 Back Flow Preventer o Grease Interceptor(Trap) gallons(Requires 3 sets of ply
o Lawn Sprinkler System Number of Heads 0 Well . **
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspectior
D 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
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 specii
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 constructic
Property Owners Name i V E %00 Ct 0 w. S Phone Number
Plumbing Company A./61,501A/ Pi.0 r. 3 i 44 (t, TAC. Office Phone U2-- `i e8 c.( Fax
Co.Address: L 2 — IAV 1 s ( , P / •., :4(ax State 1 ,Zip 3 22.5
1, z8.: .• •cation/Re on#License Holder(Print): B � _ DAM/4,f,r, ��rce Solder "� ia1e
�w:ry USaP.BASS
: ..
:.: � ,.; MY COMMISSION k FF 900342 Sworn and subscribed before m- this I 1 'AI I. A 20 f
. w EXPIRES:November 16 2019 _14_7,
u1F pd Vim' Bonded Thru Notary Pubk Underwriters
_ Signature of Notary Public ♦ A i