2060 BEACH AVE PLUMB PERM f
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
r PLRS19-0040
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 2/20/2019
19 ATLANTIC BEACH. FL 32233 EXPIRES: 8/19/2019
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 • ' + 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: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
2060 BEACH AVE PLUMBING RESIDENTIAL PLUMBING - 4 FIXTURES $1200.00
TYPE OF
ZONING: :D •
CONSTRUCTION: NUMBER: GROUP:
169713 0020 NORTH ATLANTIC BCH
UNIT3
COMPANY: ADDRESS:
STYLES SMITH PLUMBING 1537 PENMAN RD SUITE A JACKSONVILLE FL 32250
BEACH
• ADDRESS:
GLASSER ELLEN 2060 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.
F 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 4S5-0000-322-1000 0 $55.00
PLUMBING FIXTURES 4SS-0000-322-1000 4 $28.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4SS-0000-208-0600 0 $2.00
TOTAL: $87.00
Issued Date: 2/20/2019 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
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERM T#: R J! -�(•'�!
Ll
JOB ADDRESS: ^� 0 LlILI l I 14ve, PROJECT VALUE$1?
I a a0 va
2 EW OR REPLACEMENT INSTALLATION and/or ❑RE-PIPE P L R S L 9 -0O'e4 0
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory - Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS
❑ Sewer Replacement
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler heads)
❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Well **SJRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.**
❑ Other ���' W�L �-U� ��' a�le o� Lu✓ -FavLefS•
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.
I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances
governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions
of any other state orC local law regulation construction or the performance of construction.
Owner Name: l.. f I C ,r1 t t q SS Phone Number:
p y: S�-V�P_ S S �h / V' � ;/1' ff ce Phone:
Plumbing Company: M, -j ��� � 3� Fax
Co. Address: 7 )'7P/),,07M j d• City: 3.-,)< D CAG� State:FJ,.Zip:
License Holder: JI ,d elcJ PJM th State Certification/Registration # LFC. 14A 0&0vZ
Notarized Signature of License Holder
The foregoi instrumen was acknowledged before me this L�a I' 20�in the State of Florida,
County of
Signature of Notary Publi '0— -1,.
[ ] Personally Known OR [ ] Produced Identification
; R:'Pygr/. TONI GINDLESPERGER Type of Identification:
*: Er. MY COMMISSION#FF 924951
. rA$ EXPIRES:October 6,2019 Updated 10/17/18
y
Bonded Thru Notary Public Underwrt?rs