2343 Beachcomber Tr PLRS19-0126 20 Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0126
800 SEMINOLE ROAD
ISSUED: 7/1/2019
EXPIRES: 12/28/201
ATLANTIC BEACH FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • ' CONFORM • THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, AND OF + NTIC 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:
2343 BEACHCOMBER TR PLUMBING RESIDENTIAL PLUMBING - 20 FIXTURES $5700.00
OF +
ZONING: : t •
GROUP:
• •
169463 0145 OCEANWALK UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP
COGBURN AND 17C Ponte Vedra Ct Ponte Vedra Beach FL 32082
WAKEFIELD PLBG
OWNER: ADDRESS: i STATE: ZIP:
ADAMEC MARK A 2343 BEACHCOMBER TRL ATLANTIC BEACH 1 1 32233
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.
u a
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 20 $140.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.93
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $199.93
Issued Date: 7/1/2019 1 of 2
S �`�" Plumbing Permit Application **ALL INFORMATION
t' HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 PLbC Cj 1 G I ZC�
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: s -OI gfo
JOB ADDRESS: Z-S4 3 lit x-L, Co m,6.e, SFr, PROJECT VALUE$ � ?cv • �"
2 EW OR REPLACEMENT INSTALLATION and/or ❑RE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer I Shower
Dishwasher ( Shower Pan _ 2
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet �—
Hose Bibs 3 Urinal
Kitchen Sink —� Vacuum Breakers
Laundry Tray Water Connected Appliances 1
Lavatory 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 **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
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.
Owner Name: 6U C I 60SGe t tejt A^v�+ Phone Number: 70y, ZYl—°?26
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Plumbing Company: � �J L,,Up,.�-o tcy Office' hone: qO'f .f?V -45*ax
Co. Address: 30 .4,,,,a r�Lr 6t City: �� State: a zip: 3�`lS/
57
License Holder: �d� (,� �` ' State C tification/Registration # C1�2 T1 q6
Notarized Signature of License Holder
The forego " strument wa acknowledged b ore me this day ,
20�(n the State of Florida,
County of
�y TONI GINDLESPERGER Q
Yt. MYCCMMISSICN#FF 924951 Signature of Notary Public
EXPIRES October 6,2019
edThruWadP❑hcUndernters Personally Known OR Produced Identification
. Type of Identification:
Updated 10/17/18