133 Beach Ave PLRS19-0082 32 Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLR519-0082
ISSUED: 019
800 SEMINOLE ROAD EXPIRES: 10/23/2019
°+"' 10/23/ATLANTIC BEACH.FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814
Y 4 PM FOR NEXT DAY INSPECTION.
ALL • • • • EDITION 1 OF • • • ` BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF /
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: s • OF • '
install 32 fixtures for
133 BEACH AVE PLUMBING RESIDENTIAL Renovation and Porch $30000.00
Enclosure
TYPE OFREALESTATE Z :
USE
• SUBDIVISION:
CONSTRUCTION: GROUP:
170213 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
TDG PLUMBING 4426 LOYS DR JACKSONVILLE FL 32246
• ADDRESS: CITY: STATE: ZIP:
SCROGINS WILLIAM C 2000 CHEROKEE DR NEPTUNE BEACH FL 32266
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 455-0000-3231000 0 $5500
PLUMBING FI%TURES 11.000-332-1W0 33 $22°'00
STATE BBPfl SURCHARGE 455-0000-200-0200 0 $l19
STATE c.SURCHARGE 455-0 20M600 0 $2.79
TOTAL:$285.98
Issued Date:4/26/2019 1 of 2
U
**ALL INFORMATION
Plumbing Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY 15 REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept(al COab.Us PERMIT p:
JOB ADDRESS: I \ Q C'�-N i—�J -Q _ PROJECT VALUE$ X422-0
El NEW OR REPLACEMENT INSTALLATION and/or ❑RE-PIPE K25 {q - Do$a
TYPE OF FIXTUREQTY TYPE OF FIXTURE QTY
Bathtub 5 Septic Tank&Pit
Clothes Washer Shower _
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink _
Floor Sink Toilet 2_
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
LaundryTray Water connected Appliances
Lavatory Water Heater 2
Other FixtureWater 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 **S/RWD 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.
e
Owner Name: Phone Number:
CT�� n�
Plumbing Company:- -�-J`�` 9 Office Phone: �yS'7��_Fax S�y _( $S 8
Co.Address: City: E'L'F State: Zip:
License Holder: I r/AJCg 0 Co ✓sP�i State Certification/Registration if
Notarized Signature of License Holder �� �------------ ^
The foregoing instrument was acknowledged before me this(3) day ofd 20_LC� in the State of Florida,
County of 10 wd ft I,
JENNIFERJOHNSTON Signature of Notary Public
My COMMISSION 1 GG 012994
EXPIRES:OcbLer2T,2020 �
f¢":: 9a,m,atnNNmnPu9ls unlewnl4n lV Personally Known OR[ ] Produce dentification
sY^••,w Type of Identification:
Updmed10/17/19