1850 BEACH AVE - PLUMBING SHOWER PAN 01.A`poo PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
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CITY OF ATLANTIC BEACH PLRS19-0007
ISSUED: 1/8/2019
800 SEMINOLE ROAD
vk ATLANTIC BEACH. FL 32233 EXPIRES: 7/7/2019
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:
1850 BEACH AVE PLUMBING RESIDENTIAL PLUMBING -SHOWER PAN $500.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169531 0100 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
THE PLUMB ER 12130 Milford LN JACKSONVILLE FL 32246
OWNER: ADDRESS: CITY: STATE: ZIP:
LOWE DARREN C 1850 BEACH AVE ATLANTIC BEACH FL 32233
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 0 $0.00
PLUMBING FIXTURES 455-0000-322-1000 1 $7.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $66.00
Issued Date: 1/8/2019 1 of 2
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Plumbing Permit Application **ALL INFORMATION
J �S'`'1�`� HIGHLIGHTED IN
---I '` a City of Atlantic Beach Building Department GRAY IS REQUIRED.
5111 - 800 Seminole Rd, Atlantic Beach, FL 32233 I c q
'-=-� Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: PLRSt 1 -0007
JOB ADDRESS: 1.5' s7) jeL.c4) 2-2-3 .3 PROJECT VALUE$ f (JCP, 00
✓❑'SEW OR REPLACEMENT INSTALLATION and/or ❑RE-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
❑VIISCELLANEOUS
El Sewer Replacement
❑Back Flow Preventer
D Lawn Sprinkler System (number of sprinkler heads)
Ll rease Interceptor (Trap) gallons (Requires 3 sets of plans)
Ei Well **SIRWO 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: 0,4PRE Lt)IV Phone Number: 2O3 -105`1- lD (/27
Plumbing Company: T1-1-- PLUM(' i R LLC_ Office Phone: got.' 23Rg-`1' .-9 Fax o(/)-qq- 8.24,9
Co. Address: 301-)--1 M I LIF 2.0 L-NJ City: 1/k &S l) LLe State: �ti Zip: .32-2_11(0
License Holder: E7/ -y Lit'Cryo I State Certification/Registration # I/06 1&,;--/
Notarized Signature of License Holder -7��- %;7/.----
The foregoing instrument was acknowledged before me this g-ik day of,TJcNl t1 , 20 I() , in the State of Florida,
County of i�u vL.
"" MELANIE A.OAAUNGTON
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'I. Notary Public-State of Florida Signature of Notary Public%c) .I ���• C6AL7
1• , Cotrtmlesion 0 FF 953997
• •t. _ My Comm.Expires May 15,2020
'4`"'1 lond:dthrough Nalional Notary A„n. 1[ ersonally Known OR [ ] Produced Identification
Type of Identification:
Updated 10/17/18
CITY OF ATLANTIC BEACH
800SEPINOLE RD
ATLANTICBEAC,FL 32233 Cash Register Receipt Receipt Number
01'062019 15:43:02 City of Atlantic Beach R7788
CREDIT CARD
100.Mr
Cards XX0000(XXXXXX2763 'TION ( ACCOUNT I QTY I PAID
SEQ u: 8 $55.00
Batch#: 766
INVOICE 8 ress: 1747 LIVE OAK LN APN: 172020 0184 $55.00
Approval Code: 24464C
Entry Method: Manual TION FOOTING 01/08/2019 M.I $55.00
Mode: Only OUNDATION FOOTING 45500003221002 0 $55.00
Card Code: M ) MJ
CEIPT: R7788 $55.00
SALE AMOUNT $55.00
CUSTOMER COPY
Date Paid:Tuesday,January 08, 2019
Paid By: GAMEL CONSTRUCTION CO., INC.
Cashier: BA
Pay Method: CREDIT CARD 8
Printed:Tuesday,January 08,2019 3:45 PM 1 of 1 ir