606 Coastal Oak Ln PLRS19-0158 40 Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
r � CITY OF ATLANTIC BEACH PLRS19-0158
J v 800 SEMINOLE ROAD ISSUED: 8/23/2019
ATLANTIC BEACH. FL 3.2,233 EXPIRES: 2/19/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY 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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
606 COASTAL OAK LN PLUMBING RESIDENTIAL PLUMBING - 40 FIXTURES $10000.00
TYPE OF
ZONING: :D •
• • GROUP:
169505 2010 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: ADDRESS:
NELSON PLUMBING CO. 11624-1 DAVIS CREEK ROAD EAST JACKSONVILLE FL 32256
INC.
• ADDRESS:
DAVID SCOTT ARNOLD 3528 VALVEREDE CIRCLE JACKSONVILLE FL 32224
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.
LISTIOF CONDITIONS
-7 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 4SS-0000-322-1000 0 $55.00
PLUMBING FIXTURES 4SS-0000-322-1000 0 $0.00
PLUMBING FIXTURES 4SS-0000-322-1000 40 $280.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $S.03
STATE DCA SURCHARGE 4SS-0000-208-0600 0 $3.35
Issued Date: 8/23/2019 1 of 2
Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department G Y REQU ED.
Y j
800 Seminole Rd, Atlantic Beach, FL 32233 � s ( � '0(S
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 2t S Iq '0206
JOB ADDRESS: OCA 4 2dSTtY 1 (-IAkS esti PROJECT VALUE$
EW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank & Pit
Clothes Washer ( Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet _
Hose Bibs L_ Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray I Water Connected Appliances Z
Lavatory 6_ Water Heater
Other Fixtures _ Water Treating System
❑MISCELLANEOUS ;
❑Sewer Replacement l�
[]Back Flow Preventer
❑Lawn Sprinkler System (number of sprinkle hea
❑Grease Interceptor(Trap) gallons (Req Ires 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:'{ h-,t 6rJ — 69,,VOW 12ES►_o kj(-.p Phone Number:
Plumbing Company:41k-kd#4 PLfdP"b 46 /'?a -T JC, Office Phone: Z(72 — yl•�8'1 Fax
Co. Address: 2 -( OAV% L City: c State:A Zip: �Z2S6
License Holder: 920,r(- &- s.J t ertification/Registration # e2-O 3 7
Notarized Signature of License Holder PAM/
The fore g iinstrument was acknowledged befo a me this ay of }' , 20�9, in the State of Florida,
County of
p.., . USA P.BASS Signature of Notary Public
.: MY COMMISSION#FF
EXPIRES:November 16,20tJ
Bonded Nu NotaryPubkcundepwiters [ ersonally Known OR [ ) Produced Identification
Type of Identification:
Updated 10/17/18