1929 Seminole Rd PLRS19-0085 plbg permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0085
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 4/30/2019
EXPIRES: 10/27/2019
ATLANTIC BEACH, FIL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, 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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1929 SEMINOLE RD PLUMBING RESIDENTIAL install shower pan $800.00
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1695420526 BEACHSIDE
COMPANY: ADDRESS: CITY: STATE: ZIP:
KENNEDY PLUMBING INC 2517 SHADYWOODS DRIVE MIDDLEBURG FL 32068
OWNER: ADDRESS: CITY: STATE: ZIP:
LAMBERT MARK S 1929 SEMINOLE RD ATLANTIC BEACH FL 32233-5903
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
i 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 1 $7.00
STATE DBPR SURCHARGE 45S-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$66.00
Issued Date:4/30/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0085
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 4/30/2019
ATLANTIC BEACH, Fl.32233 EXPIRES: 10/27/2019
Issued Date:4/30/2019 2 of 2
K_L,U M.D'I iN ky r ul RIVI 1.1 '�A MI.tL,A 1 UN
CITY OF ATLANTIC BEACI-1
800 Seminole Rd Atlantic Bca.,h, FL 32213
Ph (904) 247-5826 Fax (9049 247-5845
.JOB AT)Dimss: F— M t'A)o�F_ P, 0 ML 6 EA c' 10— 3 Z-1 3 3 PERM IT#
PLI—S161 — CORE
NEW OR REPLACEMENT INSTALLATION., ProjectVallues ' Otiloo
Tw%ror, FuTURE QTY Tyzkr or, FixTu?E, QTY
Ilatlittib Sept c,Tank& 1) t
Clothes Washer SlIoNver
Disliwasher Sholver Pan
Drinking �Otintflin Slop Sink
Floor Drtiin Thr(w Cornpartniont Sink
Floor Sink Toilet
I-lose Bibs Urin 11
Kitchen. Sink Vacuuni Breakei i
Latindry Tray Water Connectec Appliances
Lavato!'.Y Water Heater
00101. l'iXtures ystern
RE-PIPE:
Tyjm,we r,ixYuRL,: QTY TYPI"OFFlIXTME QTY
Batlittib Sept o Tank& P t
Clothes Washol. Shm Vol,
Dishwasher Shower Pan
Drinking Fotintain Slop Sink
Floor Drain Thre�conipartir alit Sink
1','Ioor Sink Toilet
Hose Bibs urill 11
Kftdien Sink Vact uni Breakei
Latill(Il'y'l"ray Wata Conneetc( Appliances
Lavatory Watk Heater
Other Fixtures WRt( r Treat i rig 5 ystcrn
MISCFAXANEO US:
L.) Sewer Replacement i..i Back Flow Preventer i..j Grease Intercaptor(Trap,' 8 ; of plaws)
__gallons(Reqtilre 3 s,
F-i Lawn Sprinkler Systcm-Number of Heads El N/oil *44
S.IRWD Well Comj.71elion Jr4or-m. Cornpleted 11orm to bewbnnittec to the BUil ding Department for fintill iii i !ction,",
o Other
I'annit becoines void if'work does not 00111111011CO Withill(18iX 111011th I)OHOLI OFWOrk is sus)eadod or abili lonod Ibi,six niontlis. I hereby cerlify Ili I litive i'Ctl(l
rni g this work will be complied with wh(l specified
this tipplication tind know the stime to be LrL10 an(l corrout. All provisions oriaws and ordit ances 4oveiiii,
x
or not, The pernill dous not givc authority to violutu(lic provisions or nay otlierstatu or loatl low rugulati )n cons(niction or tho performanco or itruution.
Property Owners Name . �A P L. Phone Number q6*7 40 1
VP
Plumbing Company kp-&&ejo,y PL u mos e vv t, :*v -office Ph )ne tOtt'054 14 A vax
Co, Address:IT I I s'jJAdy W00106 City ffi�4AL'elkw� — Statefl- Zip !l2atal,
License Holder(Print): EIA6EIve State Cord,:leation/I.I.egistration V.CFC 9 3di
Notarized Signature qf'License H older e�
tAla I � ,lpl, .- ...-dau*,*.Mwmm*"Mom"i"Awm Swoi-iiaiiddsci-ib�edbelbreiiit!'tlii,s 2-11 day of A'4'rL L_- 2 0 11
JOSI-IX,HUGHES
gq MN,,
Commission 0 00 127146 Signature of Notary Public
Expifes July 23,2021
T /T 'aDVd S068Z8ZV06 09LZ-JM ST: 60 6T0Z'0C *.1d�f
Cash Register Receipt Receipt Number
City of Atlantic Beach R8889
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $66.00
PLRS19-0085 Address: 1929 SEMINOLE RD APN: 169542 0526 $66.00
PLUMBING $62.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 1 $7.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R8889 $66.00
Date Paid:Tuesday, April 30, 2019
Paid By: KENNEDY PLUMBING INC
Cashier: CT
Pay Method: CREDIT CARD 09918C
Printed:Tuesday,April 30,2019 10:04 AM 1 of 1