330 Ocean Blvd PLRS19-0064 plbg permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
r a CITY OF ATLANTIC BEACH PLRS19-0064
ISSUED: 3/27/2019
800 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 9/23/2019
MUST CALL INSPECTION PHONE • . PM FORDAY • •
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF ! ' iBUILDING
CODE, NEC, IPMC,AND CITY OF • i OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, , i
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:
330 OCEAN BLVD PLUMBING RESIDENTIAL PLUMBING - 4 FIXTURES $2000.00
TYPE OF
ZONING. :D •
• • GROUP,
170176 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
TURNER PLUMBING CO. 1903 HENDRICKS AVE JACKSONVILLE FL 32207
• ADDRESS:
KANE JOAN F 330 OCEAN BV ATLANTIC BEACH FL 32233-5336
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 45S-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 0 $0.00
PLUMBING FIXTURES 455-0000-322-1000 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:3/27/2019 1 of 2
Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
g "P City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
(tel-`251 -00&Z�
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 3J C> OPROJECT VALUE $�o
F-1 NEW OR REPLACEMENT INSTALLATION and/or El RE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan f
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 1
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Z 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: �� i0� ti Phone Number: 4Lz3 YP
Plumbing Company:�� ✓it.e-✓ T �[R Office Phone: 7(s►"'TJ�'t' Fax 3ci&—_734(D
Co. Address: (983 City: -j4c-_3_ State:E;J_Zip:
32Z�
License Holder: � � t �� -cam (� State Certification/Registration # (:S:�-- 024'[4-(0
Notarized Signature of License Holder
The foregoing instrum nt was acknowledged before me thisl" day of (rte y��-� , 20J9, in the State of Florida,
County of V
.+. Signature of Notary Public
.......... (0
LORII DIAZ
�,I emm"10NI1GG2RIM [ J Personally Known OR [ ] Produced Identification
�`. EXPIRES:Nawe�
70f low �t Type of Identification:.— ir C' .�COZ
Updated 10/17/18
l
Cash Register Receipt Receipt Number
City of Beach •
574
DESCRIPTION • QTY PAID
PermitTRAK $87.00
PLRS19-0064 Address: 330 OCEAN BLVD APN: 170176 0000 $87.00
PLUMBING $83.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 4 $28.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL11
Date Paid: Wednesday, March 27, 2019
Paid By: TURNER PLUMBING CO.
Cashier: CB
Pay Method: CREDIT CARD 9834t
00
Printed:Wednesday, March 27, 2019 3:41 PM 1 of 1 1
I RU(ii