1912 Oak Circle PLRS19-0105 7 Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLR519-0105
800 SEMINOLE ROAD ISSUED: 6/4/2019
4,, 9— ATLANTIC BEACH, FL 32233 EXPIRES: 12/1/2019
INSPECTIONMUST CALL •NE LINE (904
CODE, AND CITY OF • • 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.
• • ADDRESS:
1912 OAK CIR PLUMBING RESIDENTIAL install 7 fixtures for interior $100.00
remodel
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1720201254 SELVA MARINA UNIT
12A
COMPANY: rr •
ZELLNER'S PLUMBING AND 5744 Floral Ave JACKSONVILLE FL 32211
CONST.
• ADDRESS:
COOK THOMAS J 1912 OAK CIR ATLANTIC BEACH FL 32233-4506
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.
LISTOF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAIDAMOUNT
PLUMBING BASE FEE 4550000-322-SOW 0 $55.00
PLUMBING FIXTURES 4550000-322-10007 $4940
STATE OBPR SURCHARGE 455.0000-208-0700 0 $2.00
STATE OCA SURCHARGE 455-0000-208-0600 1 0 $2.00
Issued Date:6/4/2019 1 of 2
YI PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLR519-0105
lz
ISSUED: 6/4/2019
800 SEMINOLE ROAD
EXPIRES: 12/1/2019
T"yr ATLANTIC BEACH,FL 32233
TOTAL:$308.00
Issued Date:6/4/2019 2 of 2
0
INFORMATIONPlumbin Permit Application HIGHLIGHTEDIN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904)r2'4tL7-5826 Email: Building-Dept@coab.us PERMIT q:??LM(ft—
ADDRESS: No, "
O (O�
�L1P,eB ADDRESS: I q IZ hk CJ .JL PROJECT VALUE $ N o, ""
NEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE _ QTY
Bathtub I Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan - I
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 7-
Hose Bibs Urinal
Kitchen Sink I Vacuum Breakers
LaundryTray Water Connected Appliances
Lavatory Y 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 specked or not. The permit does not give authority to violate the provisions
of any other state or local law re lati n construction or the performance of construction.
1
Owner Name: // L Phone Number:
Plumbing Company: CLjjAb7LS Plw^'t t _Office Phone: # 7x'7 lk>9 Fax
Co.Address: SZCity: Stater Zip: 37ttl
License Holder: t G State Certification/Registration q C.j�r_IYt2'737<
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this day of JtllA.1 , 20h in the State of Florida,
County of hii0 I,J
Signature of Notary Public
JENNIFER Jorc ,
xncommissloIIN ncc oazsea )
I f 1 Personally Known I
KOR ced rodulyntificatioli
s`2 EXPIRES'.Oct r27,2020
art;,¢:+: aom.a TNU Nortry emm ume�.ateo Type of Identifications f•L— n� ¢-� S\uLLAK
Updmedm/12/18