1607 Atlantic Beach Dr PLRS19-0019 plbg permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0019
800 SEMINOLE ROAD ISSUED: 1/22/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 7/21/2019
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:
1607 ATLANTIC BEACH DR PLUMBING RESIDENTIAL install 24 fixtures $10000.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1695051065 ATLANTIC BEACH
COUNTRY CLUB UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
RINKWELL PLUMBING INC 5105 PHILIPS HWY JACKSONVILLE FL 32217
OWNER: ADDRESS: CITY: STATE: ZIP:
TOLL FL VI LIMITED 250 GIBRALTAR RD HORSHAM PA 19044
PARTNERSHIP
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
PLUMBING FIXTURES 455-0000-322-1000 24 $168.00
STATE DBPR SURCHARGE 4S5-0000-208-0700 0 $3.35
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.231
TOTAL:$228.58
Issued Date: 1/22/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0019
CITY OF ATLANTIC BEACH ISSUED: 1/22/2019
800 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 7/21/2019
Issued Date: 1/22/2019 2 of 2
Plumbing Permit Application
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 12ESA-627
JOB ADDRESS: PROJECT VALUE
aEW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Q Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Dra in 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
Elm[SCELLANEOUS
0Sewer Replacement
G2Kack Flow Preventer
El Lawn Sprinkler System (number of sprinkler heads)
DGrease Interceptor(Trap)_gallons (Requires 3 sets of plans)
n 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:_�T� Phone Number:
T]
Plumbing Company:
1�j( Office Phone: Fax 64��32�-5'I
Co. Address: City: State: zip:
License Holder: 751!, k State Certification/Registration #
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this day of 201�, in the State of Florida,
County of
Public
BEVERLY D.PINK Signature of Notary
My COMWSS10141 I FF 941131
EXPIRE&Ap6i 3.2020 M"i3ersonally Known OR Produced Identification
�r Boww TM W
Type of Identification:
Updoted 10/17118
Cash Register Receipt Receipt Number
City of Atlantic Beach R7905
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $228.581
PLRS19-0019 Address: 1607 ATLANTIC BEACH DR APN: 169505 1065 $228.58 1
PLUMBING $223.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 24 $168.00
STATE SURCHARGES $5.58
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.35
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.23
TOTAL FEES PAID BY RECEIPT: R7905 $228.58
Date Paid: Tuesday, January 22, 2019
Paid By: RINKWELL PLUMBING INC
Cashier: CB
Pay Method: CREDIT CARD 8587g
Printed:Tuesday,January 22,2019 2:57 PM 1 of 1