0 Begonia St PLRS19-0106 13 Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0106
800 SEMINOLE ROAD ISSUED: 6/6/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 12/3/2019
MUST CALL INSPECTION PHONE • 1 FOR •
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, ' OF BEACH CODEOF 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:
0 BEGONIA ST PLUMBING RESIDENTIAL PLUMBING - 13 FIXTURES $9000.00
TYPE OF
ZONING: :D •
• • GROUP:
1709210000 ATLANTIC BEACH SEC H
COMPANY: ADDRESS:
C&J Plumbing Service, LLC 54110 Marlee Road Callahan FL 32011
• ADDRESS:
HOLSTAR LLC 6685 BOWIE RD JACKSONVILLE FL 32219
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 • •
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 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 0 $0.00
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: $150.19
Issued Date:6/6/2019 1 of 2
PLUMBING PERI 11, APPLICATION o
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
Job ADDRESS: J,,9 f' s PERMIT# S/
NEW OR REPLACEMENT INSTALLATION: Project Value$�
TYPE OFFIXTvRE QTY TYPE oFFixTuRE QTY J
Bathtub ' I _ Septic Tank&Pit
Clothes Washer i Shower O
Dishwasher �_ Shower Pan
Drinking Fountain Slop Sink
Floor Sink Q
Floor Drain Three Compartment Sink
Toilet
Hose Bibs �= Urinal
Kitchen Sink __j_ Vacuum Breakers
Laundry Tray Water Connected Appliances (�
Lavatory _�3 _ Water Heater
Other Fixtures Water Treating System
RE-PIPE: r
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 ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ElWell **
**SJRWD Well Completion Form. Completed foim 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.
Property Owners Name Phone Number
Plumbing Company C q k J W09, V h Se K u C Office Phone 97b Fq e)2 Fax
moo. Address: City'`,C i4 l Ire-It o'.1 State r�_Zip
License Holder(Print): A-rc� l�. of 0,5 J State Certification/Registration#C fe 114 2 9(p- (e
Votarized Si nature o .license Holder
K.COON
:
MY r ,W,1.JN#GG 063988 efore me this
N day of _ 20�_
?� E.. -iES:%,irch 25,2021
Awo. Bondw u«•,INoWy Pubk unaerwrrers ignature of Notary Public �� �