2279 Seminole Rd Unit 10 PLRS19-0078 H20 Heater r' PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
`A CITY OF ATLANTIC BEACH PLRS19-0078
800- ISSUED:4/18/2019
. r ATLANTIC
EACH.NOLE ROAD EXPIRES: 30/15/2019
ATLANTIC BEACH. FL 32233
INSPECTIONMUST CALL
•NE LINE (904
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITIONr OF • ' rA BUILDING
CODE, NEC, IPIVIC, 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.
• • . • r • r • OF • •
2279 SEMINOLE RD UNIT 10 PLUMBING RESIDENTIAL PLUMBING -WATER HEATER $1300.00
TYPE OF BUILDING
CONSTRUCTION: NUMBER: GROUP:
168345 0175 SECTION LAND
COMPANY: ADDRESS:
Clay County Master 449 Arthur Moore Dr GREEN COVE FL 32043
Plumbing LLC SPRINGS
• ADDRESS: CITY: STATE: ZIP:
DRISCOLL KEVIN 1 2279 SEMINOLE RD #10 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.
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 4550000322-1000 0 $5500
PLUMBING FIXTURES 455-0000322-1000 0 50.00
PLUMBING FIXTURES 455-0000.322-1000 1 $7,00
STATE DERR SURCHARGE 455 MM208-0700 0 $240
STATE DCA SURCHARGE 4550000-208-0600 0 $200
TOTAL:$66.00
Issued Date:4/18/2019 1 of 2
Plumbing Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 D
Phone: (904) 247-5826 Email: Building-Dept(Crrlcoabms PERMIT ir:P LRS(9-DOT
JOB ADDRESS: 2279 Seminole Rd#t10 PROJECT VALUE$ 1300.00
EaIIEW OR REPLACEMENT INSTALLATION and/or aE-PIPE
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 "SIRWD 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.
fne�.J Cw"r—
Owner Name:Erica Hoffman / 1/\eV t n p.cS as ( ( Phone Number: 757-343-6153
Plumbing Company: Clay County Master Plbg LLC Office Phone: 904-589-9666 Fax 904-212-2828
Co. Address: 706 Charles Pinckney St City: Orange Park State: FL Zip: 32073
License Holder: James K Pelky / tatte Certification/Registration 11 CFC058079
Notarized Signature of License Holder Zaae
The foregoing instrument was acknowle ged before me this ) ay of1120f 1, in the State of Florida,
County of
Signature of Notary Public
David Smolder
�OOc, Notary Public
State of Florida [ 1 Personally Known OR[ roduced Id ntification
My Commission Expires W0312022 Type of Identification: I-L t7(r
Commission No.GG 241428 U000teaio/v/ia