2265 Beachcomber Tr PLRS19-0143 Shower Pan PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
PLRS19-0143
8
ISSUED: 7/17/2019
00 SEMINOLE ROAD
°file` ATLANTIC BEACH. FL 32233 EXPIRES: 1/13/2020
MUST CALL INSPECTION • • • + PM FOR DAY INSPECTION.
ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + BUILDING
CODE, NEC, IPMC, AND OF ATLANTIC + CH CODE OF ORDINANCES .
ALL • i OF PERMIT APPLY, PLEASE READCAREFULLY.
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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
2265 BEACHCOMBER TR PLUMBING RESIDENTIAL PLUMBING -SHOWER PAN $1200.00
TYPE OF +
ZONING: : • •
CONSTRUCTION: GROUP:
169463 0158 OCEANWALK UNIT 01
COMPANY: AOORESS: CITY: STATE: ZIP:
ELITE PLUMBING LLC 944 STEEPLE CHASE LANE ORANGE PARK FL 32065
• ADDRESS:
KENNELLY BRADLEY JR 2265 BEACHCOMBER TRL ATLANTIC BEACH FL 32233-4567
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 . r •
iRoll off container company must be on City approved list . Container cannot be placed on City right-of-way.
I
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 1 $7.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.58
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
WORK WITHOUT PERMIT 455-0000-322-1000 0 $110.00
TOTAL: $176.58
Issued Date: 7/17/2019 1 of 2
_ Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
s�
V 800 Seminole Rd, Atlantic Beach, FL 32233 �L jZS C C� _ 0143
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: A+(^kJ-hc al, PROJECT VALUE$ hW0
❑NEW OR REPLACEMENT INSTALLATION and/or ORE-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
E:1 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: (a) V,A f�)L� Phone Number:
Plumbing Company: Elt4e LLC Office Phone: 3t'fytoz Sg73 Fax
Co. Address: 9LA( _ftt?,0eCV*SE. cjL3 City: DeA#jetG. ref-L State: FL Zip: 32atoS
License Holder: L-U*jt L e. aATtA t*_7^F-. State Certification/Registration # are_t425IN33
Notarized Signature of License Holder
The foregoi strumien was acknowledged before me this day 0 2011 in the State of Florida,
County of
Signature of Notary Public
[ ] Personally Known OR [ ] Produced Identification
ToNIGINDLEgpERGER Type of Identification:
Y COMMISSION#FF 92c__ 11
YPIRES:October 6,20 9
6.. ;j ThN Notary'ublic Underact
P Updated 10/17/18