1549 BEACH AVE PLRS19-0017 PLUMBING PERMIT PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0017
ISSUED: 1/18/2019
800 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 7/17/2019
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.
1549 BEACH AVE PLUMBING RESIDENTIAL install 44 fixtures $36000.00
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1703110000 ATLANTIC BEACH
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COMPANY: i ADDRESS: CITY: STATE: ZI
AMERICAN PLUMBING 5720 ARLINGTON RD JACKSONVILLE FL 32211
CONTRACTORS
OWNER: ADDRESS: CITY: STATE: ZIP:
CELLAR WILLIAM J 1549 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.
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DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 45S-0000-322-1000 44 $308.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $5.45
STATE DCA SURCHARGE 4SS-0000-208-0600 0 $3.63
TOTAL: $372.08
Issued Date: 1/18/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0017
CITY OF ATLANTIC BEACH
ISSUED: 1/18/2019
800 SEMINOLE ROAD
EXPIRES: 7/17/2019
ATLANTIC BEACH. FIL 32233
Issued Date: 1/18/2019 2 of 2
Plumbing Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY 15 REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 co t
Phone: (904) 247-5826 Email: 3uilciing-De� :.1c o a b.u s PERMIT#: RES18-0335
JOB ADDRESS: 1549 BEACH AVENUE PROJECT VALUE$36,000.00
OYEW OR REPLACEMENT INSTALLATION and/or nRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 2 Septic Tank & Pit
Clothes Washer Shower 5
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 8
Hose Bibs 6 Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray I Water Connected Appliances
Lavatory 1 Q Water Heater 3
Other Fixtures 8 Water Treating System
I]MISCELLANEOUS
E]Sewer Replacement
E]Back Flow Preventer
L1 Lawn Sprinkler System (number of sprinkler heads)
Ebrease interceptor (Trap)_gallons (Requires 3 sets of plans)
F]Well **SJRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.
ElOther
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:A'����� _W C 1�I a f'- Phone Number: 404- �Dlq 9�
Plumbing Company: AMERICAN PLUMBING CONTRACTORS, INC Office Phone: (904)745-1693 - Fax(904)743-9944
Co. Address: 5720 ARLINGTON ROAD City: JACKSONVILLE State: FL Zip: 32211
License Holder: RANDY MILLER State Certification/Registration# CFC056488
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this ��day of -TCQpk
20\ in the State of Florida,
County of Clwcll
... ...... LAYCI SMYTH Signature of Notary Public
P!
State of Florida-Notary Public
Commission # GG 197930
Personally Know ro ed I catio
My Commission Expires
March 19, 2022 Type of Identipe tion
Updated 10/17118
Cash Register Receipt Receipt Number
City of Atlantic Beach R7894
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $372.08
PLRS19-0017 Address: 1549 BEACH AVE APN: 1703110000 $372.08
PLUMBING $363.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 44 $308.00
STATE SURCHARGES $9.08
STATE DBPR SURCHARGE 455-0000-208-0700 0 $5.45
STATE DCA SURCHARGE 455-0000-208-0600 0 $3.63
TOTAL FEES PAID BY RECEIPT: R7894 $372.08
Date Paid: Friday, January 18, 2019
Paid By: AMERICAN PLUMBING CONTRACTORS
Cashier: CB
Pay Method: CREDIT CARD 15
Printed: Friday,January 18, 2019 3:58 PM I of 1