320 10th St PLRS19-0098 plbg permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0098
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 5/22/2019
oil 9 ATLANTIC BEACH. FL 32233 EXPIRES: 11/18/2019
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:
320 10TH ST PLUMBING RESIDENTIAL install 13 fixtures for new $12000.00
home
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER- GROUP:
1700320000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
SWEENEY REMODELING 14047 MOUNT PLEASANT ROAD JACKSONVILLE FL 32225
AND PLUMBING
OWNER: ADDRESS: CITY: STATE: ZIP:
BRECHBILL ALAN L 479 ENGLISH IVY CT HUMMELSTOWN PA 17036
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 4SS-0000-322-1000 0 $SS.00
PLUMBING FIXTURES 455-0000-322-1000 13 $91.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.19
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$150.19
Issued Date: 5/22/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0098
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 5/22/2019
Dili,' ATLANTIC BEACH. FL 32233 EXPIRES: 11/18/2019
Issued Date: 5/22/2019 2 of 2
SW 0'0 /)1, � a o a � (C116 MMI I %co t L3�
Plumbing Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
wl 19 Phone: (90 ) 247-5826 Email: Building-Dept@coab.us PERMIT#: PLLS('q - 6)0��&
JOB ADDRESS: u*-0— PROJECT VALUE 'W'49
REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I— Septic Tank& Pit
Clothes Washer t 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
E:1 MISCELLANEOUS
Ei Sewer Replacement
El Back Flow Preventer
El Lawn Sprinkler System (number of sprinkler heads)
11 Grease Interceptor (Trap) _gallons (Requires 3 sets of plans)
Lj Well **SJRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.
Li 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 locjL law r�guljtjon construction or the performance of construction.
Phone Number: q0L( 3c)3 6q?t:7
0 w n e r N a m
Plumbing Company: 04-' N- Cr: - 'A.,Tie. Office Phone: SO'5 6(f��7 Fax
Co. Address: ISCYLI-t City: ).tkso it a,I State:--�—. zip:
License Holder: e k�7-Z '33:7
c <Z,,j State Certification/R ! istr
Notarized Signature of License Holder
The foregoing instrument was ackno �ged before me this_�'�day of V((kx( 20-1�)in the State of Florida,
County of
Signature of Notary Public
Updoted 10/17118
ON
oa y JENNIFER JOHNS
c-
Type of I
XPIRES:October 27
Is Pubi nderwiters
COMMISSION#GG 042984 Personally Known (DR [U'�roclu ediden 3tion
2020 Identification:
n!r Bonded Thru Notary Public
'Z�4".
I'L.— iaigigimm—
Cash Register Receipt Receipt Number
City of Atlantic Beach R9125
DESCRIPTION ACCOUNT QTY PAID
PermitTRA $150.19
PLRS19-0098 Address: 320 10TH ST APN: 170032 0000 $150.19
PLUMBING $146.00
PLUMBING BASE FEE 455-0000-322-1000 0 $SS.00
PLUMBING FIXTURES 455-0000-322-1000 $91.00
STATE SURCHARGES $4.19
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.19
STATE DCA SURCHARGE 455-0000-208-0600 0 �2.00
TOTAL FEES PAID BY RECEIPT: R9125 $150.19
Date Paid: Wednesday, May 22, 2019
Paid By: SWEENEY REMODELING AND PLUMBING
Cashier: CT
Pay Method: CREDIT CARD 411794
Printed:Wednesday, May 22,2019 3:34 PM 1 of 1