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2004 BEACH AVE PLUMB PERM PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH PLRS19-0038 yr 800 SEMINOLE ROAD ISSUED: 2/14/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 8/13/2019 MUST CALL INSPECTION PHONE LINE (904) 247-S814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' 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: 2004 BEACH AVE PLUMBING RESIDENTIAL PLUMBING - 3 FIXTURES $1000.00 TYPE OF • ZONING: :D • i • GROUP: 169702 0050 NORTH ATLANTIC BCH UNIT 3 • P_ ADDRESS: CITY: STATE: ZIP: TDG PLUMBING 4426 LOYS DR JACKSONVILLE FL 32246 • ADDRESS: CITY: STATE: ZIP: CARPENTER F KENDALL 2006 BEACH AVE ATLANTIC BEACH FL 32233-5935 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. 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 3 $21.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$80.00 Issued Date: 2/14/2019 1 of 2 Plumbing Permit Application **ALL INFORMATION HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 PLA S 19 -00 _E>45 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: I!j - oo_3'� JOB ADDRESS: Ooh C\)6_ 1_�0 e-- PROJECT VALUE $ / © O 0-- `S>`D ❑NEW OR REPLACEMENT INSTALLATION and/or E:1 RE-PIPE TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank& Pit Clothes Washer Shower 1 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. Owner Name: Phone Number: Plumbing Company: -T-o Office Phone: SH 6'7_-'s'I I Fax Co. Address: �y a L L-o`I, J �2- City: ��9-N State: Fj_ Zip: -A 2'Z-9 License Holder:-7aA�1. ' 6A,"nKt -�--� State Certification/Registration # (f FC- 14Z7:_�c6Z Notarized Signature of License Holder —tet The foregoin trument as acknowledged before me this ay , 20 in the State of Florida, County of {� Signature of Notary Public 4 .,pLr �UyyIetNCLES?ERGER r personally Known OR [ ] Produced Identification :_ 4 P,;?CUh"Mi531gi� F�924951 `f, , _•: = EKPIRFS3 octob, aero Type of Identification: f i ccntlod Yhru�o�ry Pubi'w 9 "r Updated 10/17/18