1336 BEACH AVE PLRS19-0046 PLUMB PERM PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0046
V~ 800 SEMINOLE ROAD ISSUED: 3/14/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 9/10/2019
MUST CALL INSPECTION PHONEFOR • INSPECTION.
ALL • 'K MUST CONFORM TO THE CURRENT • • / OF • '
CODE, ' AND OF ATLANTIC + • OF ORDINANCES .
ALL • • OF PERMIT APPLY, r a aCAREFULLY.
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.
ADDRESS: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
1336 BEACH AVE PLUMBING RESIDENTIAL replace 2 bathtubs $1500.00
TYPE OF
• • GROUP:
171840 0000 MANDALAY
COMPANY: ADDRESS:
M &A PLUMBING INC 1186 PECAN COVE JACKSONVILLE FL 32221
• ADDRESS:
BEARDALL GEOFFREY 1336 BEACH AVE ATLANTIC BEACH FL 32233-5732
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 . •
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 4SS-0000-322-1000 0 $55.00
PLUMBING FIXTURES 4SS-0000-322-1000 2 $14.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$73.00
Issued Date: 3/14/2019 1 of 2
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800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 �SI
rOB ADDRESS: /✓1�0 �r� y[. TP"ERMT#
VEW OtYP�E
LACEMENT INET TION: Project Value$
OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub oC Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urioal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
tE-PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain SlopSink
Floor Drain Thre 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: �trx�"L 350-
i
5Qi Sewer Replacement Back Flow Preventer -3 Grease Interceptor M� W to
p (Trap) gallons(Requires 3 sets of plans)
Lawn Sprinkler System-Number of Heads Well **
" SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection."
i Other
ermit 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 re:
tis application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specifie+
r not. The permit does not give authority to violate the provisions of any other state or local la%v regulation construction or the performance of construction.
rope,On w INN ' ��(� A/// -- Phone Number
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Iumbr,I�► ,�'j_ , ���7 Office Phone - 3�� - Fax
:o. �r ` L/ dZr City A61( 1^,✓f IP State/��Zip '5 )4, �r
,iceMe old� " " } 4,;.- 'r
s � `���Z,b C State Certification/Registration# �
JotaJ 1:0; •*1 of Ij_ Mv:LWolder
�i %�•••�,••PVO�' ���` Sworn and subscribed before me this day o 20
0 d'TTE OF
111111w `'`��� Signature of Notary Public 42ALAI)
Cash Register Receipt Receipt Number
J ova "fw` City of Atlantic Beach R8425
DESCRIPTION • CITY PAID
PermitTRAK $73.00
PLRS19-0046 Address: 1336 BEACH AVE APN: 171840 0000 $73.00
PLUMBING $69.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 2 $14.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTALR8425 $73.00
Date Paid:Thursday, March 14, 2019
Paid By: M &A PLUMBING INC
Cashier: CT
Pay Method: CREDIT CARD 091762
Printed:Thursday, March 14,2019 12:52 PM 1 of 1 ji
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