1729 Ocean Grove Dr PLRS19-0073 Plumb Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0073
800 SEMINOLE ROAD ISSUED:4/10/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 10/7/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT EITH EDITION (2017) OF THE FLORIDA BUILDINJ
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
requirements of this permit,there maybe add itiona I restrictions applicable to this property
ublic records of this county,and there may be additional permits required from other
i as water management districts,state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1729 OCEAN GROVE DR PLUMBING RESIDENTIAL PLUMBING 13 FIXTURES $3500.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1696100000 OCEAN GROVE UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
C W WOOD PLUMBING 1328 ROMNEY ST JACKSONVILLE FL 32211
OWNER: ADDRESS: CITY: STATE: ZIP:
LAILIBERTE JOHN A 14370 MANCHESTER DR NAPLES FL 34114-8626
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 13 $91 no
STATE DBPR SURCHARGE 455 000010700 a $219
7 STATE DCA SURCHARGE 45S-0000 208 06W 0 $200
TOTAL:$150.19
Issued Datei 4/10/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLR519-0073
800 SEMINOLE ROAD ISSUED:4/10/2019
ATLANTIC BEACH. FIL 32233 EXPIRES' 10/712019
Issued Date:4/10/2019 2 of 2
"ALL INFORMATION
.dall Plumbing Permit Application HIGHLIGHTED IN
40 City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FIL 32233 -D I
Phone: (904) 247-5826 Email: Building-Dept@cclab.us PERMIT ill: 1 -P-3�9-C)0 3
JOB ADDRESS: 17Zq ace— 6�,-ve PROJEcrVALUE $ -�5;00
�9NEW OR REPLACEMENT INSTALLATION and/or EfRE-PIPE
TYPE OF FIXTURE OTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher ShowerPan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
LaundryTray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
DMISCIELLANEOUS
Ei Sewer Replacement
El Back Flow Preventer
Li Lawn Sprinkler System (number of sprinkler heads)
o Grease Interceptor(Trap)_gallons(Requires 3 sets of plans)
El Well **SJRWD Well Completion Form.Completed form to be submitted to the Building Depaftment for final inspection.
ED 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 certifV 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 Narne:—Lodiber-fe-- Phone Number:
Plumbing Company. 4--"006/ /O/V,�n L,�j Office Phone: '71-1�1-6� Fax_
I -4(-Zip: 37- 1, '/
CO.Address: 132 ,y' 1101-71217 S� City: 121< State:)`
0,5'70
-0-S 4'-4 -�C 17
License Holder: "5 SMe Certification/Registration #
Notarized Signature of License Holder
oregolZ Zns ru=men 20/4�4 in the State of Florida,
Thef t t as acknowledged before me this d of r--p
Cou
Signature of Notary
T.0.�ql GINDLESPERGER
r I P 11
EXPIRES.Gd&K6.M19 Personally Known OR Produced Identification
IlmdedThmWWubkUld'�— Type of Identification: ]�) (— -
)PdP�10117118