34 Dudley St PLRS19-0122 plbg permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0122
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 6/26/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 12/23/2019
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:
34 DUDLEY ST PLUMBING RESIDENTIAL 34 DUDLEY PLUMBING - 14 $6000.00
FIXTURES
TYPE OF REALIESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER, GROUP:
COMPANY: ADDRESS: CITY: STATE: ZIP:
CANNON PLUMBING, INC. 1718 EAST CHURCH STREET JACKSONVILLE FL 32202
OWNER: ADDRESS: CITY: STATE: ZIP:
JL
AMERICAN CLASSIC 4550 St Augustine Road JACKSONVILLE FL 32207
HOMES LLC
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
AT70RNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
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 $SS'00
PLUMBING FIXTURES 45S-0000-322-1000 0 $0.00
PLUMBING FIXTURES 455-0000-322-1000 14 $98.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.30
STATE DCA SURCHARGE 4SS-0000-208-0600 0 $2.00
Issued Date: 6/26/2019 1of2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0122
CITY OF ATLANTIC BEACH
ISSUED: 6/26/2019
800 SEMINOLE ROAD
19, EXPIRES: 12/23/2019
ATLANTIC BEACH, FL 32233
TOTAL:$157.3]0
Issued Date: 6/26/2019 2 of 2
"ALL INFORMATION
Plumbing Permit Application HIGHLIGHTED IN
GRAY 15 REQUIRED.
City of Atlantic Beach Building Department 9
800 Seminole Rd, Atlantic Beach, FL 32233 P LIR,
Phone: (904) 247-5826 Email: bLAildmg-Dept.(LPcoab.us PERMIT#:
JOB ADDRESS: 34 Dudley Street PROJECT VALUE $6,000.00
RINEW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE 17_Z_Z 1 C)
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 1 Septic Tank & Pit 1
Clothes Washer 1 Shower
Dishwasher 1 Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink 2
Floor Sink Toilet
Hose Bibs 2 Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray Water Connected Appliances 1
Lavatory 3 Water Heater 1
Other Fixtures Water Treating System
X
OMISCELLANEOUS
Elsewer Replacement
E]Back Flow Preventer
El Lawn Sprinkler System (number of sprinkler heads)
03rease interceptor (Trap)_gallons (Requires 3 sets of plans)
[]Well --SJRWD 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
gove ning 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.
Owner Name:American Classic Homes Phone Number: (904)351-0308
(904)744-6350 Fax(904) 551-0416
Plumbing Company: Cannon Plumbing Inc Office Phone.
Co. Address: 1718 E Church Street Citv: Jacksonville State: FL Zii): 32202
License Holder: Olin Cannon State Certification/Registration # CFC1426140
Notarized Signature of License Holder
The foregoing instrumvent was acknowledged before me this_�I�clay of �A kA't 20 in the State of Florida,
County of
Robbie Bieler
-jj L)YLA
NOTARY PUBLIC
Signature of Not; ry Public
lip STATE OF FLORIDA
Comm#GG 158647 O-P,'ersonally Known OR Produced Identification
-14C E Expires 11/7/2021 "Type,of Identification:
Updoted 10/17118
Cash Register Receipt Receipt Number
City of Atlantic Beach R9406
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $157.30
PLRS19-0122 Address: 34 DUDLEY ST APN: $157.30
PLUMBING $153.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 14 $98.00
STATE SURCHARGES $4.30
STATE DBPR SURCHARGE 455-000'0-208-0700 0 $2.30
STATE DCA SU RCHARG E 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R9406 $157.30
Date Paid: Wednesday,June 26, 2019
Paid By: CANNON PLUMBING, INC.
Cashier: CT
Pay Method: CREDIT CARD 082164
Printed:Wednesday,June 26,2019 10:37 AM 1 of 1