459 Ocean Blvd PLRS19-0131 3 Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0131
J 800 SEMINOLE ROAD ISSUED: 7/8/2019
EXPIRES: 1/4/2020
ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION • • • 1 PM FOR + INSPECTION.
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + 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.
• : + ' • • • '
459 OCEAN BLVD PLUMBING RESIDENTIAL PLUMBING - 3 FIXTURES $1000.00
TYPE OF
ZONING: :D •
• iGROUP:
170165 0000 ATLANTIC BEACH
COMPANY: D. ®�
WILLIAM'S BIG BOY 516 SOUTH 11TH AVE JACKSONVILLE FL 32250
PLUMBING INC BEACH
• ADDRESS:
GRUNTHAL LEONARD H III 459 OCEAN BLVD ATLANTIC BEACH FL 32233-5337
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 3 $21.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $80.00
Issued Date: 7/8/2019 1 of 2
Plumbing Pit Application **ALL INFORMATION
germpp
j HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS R QUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 PL_2Si _ c 3
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 11 -01'qo
JOB ADDRESS: �� O GPLQ A) a[ VDI PROJECT VALUE $ t000
/NEW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE
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
ElMISCELLANEOUS r
C_I Sewer Replacement j
❑ 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. **
CI 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 Vocal law regulation construction or the performance of construction.
Owner Name: 6TGN+i�ad. t,, Phone Number:
Plumbing Company: wtllll� � �d "IMV , Office Phone: 2� Fax
Co. Address: City: J Or-- State:'t Zip: 5
License Holder: ! ���t?A State Certification/Registration # �F66 703
Notarized Signature of License Holder
The foregoing in rument w�s acknowledged before me this__�Ja f f , 20�$ the State of Florida,
County of
70NI GINDLESPERGER Signature of Notary Public Q - –
Cj
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MY COMMISSION#FF 921,51FF_
EXPIRES.October 6,2019ersonally Known OR [ ] Produced Identification
ty Pubjcundewr onded ThuNo h /Type of Identification:
Updated 10/17/18