1770 OCEAN GROVE DR PLRS18-0298 PLUMB RES PERMIT `i1-1 `'` ' PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
Y � PLRS18-0298
CITY OF ATLANTIC BEACH
ISSUED: 12/18/2018
800 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 6/16/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' D+ BUILDING
CODEJ. 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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
1770 OCEAN GROVE DR PLUMBING RESIDENTIAL PLUMBING - WATER HEATER $810.00
TYPE OFBUILDING USE
ZONING: :D •
• • GROUP:
169619 0000 OCEAN GROVE UNIT 02
• . ADDRESS:
DAVID GRAY PLUMBING 6491 POWERS AVENUE JACKSONVILLE FL 32217
INC.
• ADDRESS:
FYFFE LARRY H 1770 OCEAN GROVE DR ATLANTIC BEACH FL 32233-5845
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 • •
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
Imo-
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 0 $0.00
PLUMBING FIXTURES 455-0000-322-1000 ? $7.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4S5-0000-208-0600 0 $2.00
TOTAL: $66.00
Issued Date: 12/18/2018 1 of 2
Plumbing Permit Application **ALL INFORMATION
1� x �� HIGHLIGHTED IN
; City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 P LIR's l g -O Z-9 g
- urttvr Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
1
JOB ADDRESS: �
PROJECT VALUE $
� i�� L �-T., {,�Y'} (�N I�I
OYEW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower 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
❑Sewer Replacement
[]Back Flow Preventer
❑Lawn Sprinkler System (number of sprinkler heads)
grease Interceptor (Trap) gallons (Requires 3 sets of 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. n } J
Owner Name: 6 Phone Number: "► �� ' -1 8��r�
Plumbing Company C'f1' t1�-t 'It,�mbit'tln Office Phone: '72�'7�� Fax
Plumbing
Co. Address: 1p q� ) POLOS k&if�t-t.1 City: �Cn( S v��1� State:rj,_Zip:
License Holder: State Certification/Registration # ("f--C () 7,`Z5�(0
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this day of , 20L�_, in the State of Florida,
County of 'Dyy o
Notary Public state&Florida
;F GrimarisRivera Signature of Notary Public
+s My Commission GG 242920
'y or Expires 07!3012022
[ Personally Known OR [ ] Produced Identification
Type of Identification:
Updated 10/17/18