377 7th St PLRS19-0159 39 Fixtures rS'rt" % PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0159
800 SEMINOLE ROAD ISSUED: 8/23/2019
~�019, ATLANTIC BEACH. FL 32233 EXPIRES: 2/19/2020
MUST CALL • • • • • i . BY 4 PM FOR NEXT DAY INSPECTION.
CODE,ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
' OF • OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE .
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:
377 7TH ST PLUMBING RESIDENTIAL PLUMBING - 39 FIXTURES $10000.00
TYPE OFREALESTATE BUILDING USE i
ZONING: : . •
• • GROUP:
169944 0000 SHERRY TERRACE R/P
COMPANY: ADDRESS:
NELSON PLUMBING CO. 11624 -1 DAVIS CREEK ROAD EAST JACKSONVILLE FL 32256
INC.
OWNER: ADDRESS:
Jeff Newman 377 7TH ST ATLANTIC BEACH FL 32233-5433
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 45S-0000-322-1000 0 $SS.00
PLUMBING FIXTURES 455-0000-322-1000 0 $0.00
PLUMBING FIXTURES 4SS-0000-322-1000 39 $273.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $4.92
STATE DCA SURCHARGE 45S-0000-208-0600 0 $3.28
TOTAL: $336.20
Issued Date: 8/23/2019 1 of 2
`rr ilr'J rlrr.,
Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department Z Y 11REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 �1-� s
� n C�
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: —Es I t -7
JOB ADDRESS: 3'1"I ---7T' STQeek-T— PROJECT VALUE $ I O i OOO , 00
EW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Z Septic Tank & Pit
Clothes Washer �_ Shower 3
Dishwasher 1 Shower Pan 21
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs 4 Urinal
Kitchen Sink Z Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 1 Water Heater 2
Other Fixtures Water Treating System
❑MISCELLANEOUS r
❑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: R)( but �DC"��� — 1A1CW 11?N 65jQ yJCE Phone Number:
Plumbing Company: Alclsbh/ Pjk*lbfn •ytpffice Phone: 2k-Z - t($8 7 Fax
Co. Address: 6� i 44�C. City: State: (--%- zip: ZS�
License Holder: orT Al I k p^J S a rtification/Registration # 02037 '
Notarized Signature of License Holder
The foregoi trument,�vas acknowledged before me this Ljda of , 20�, in the State of Florida,
County of
USA BASS ignature of Notary Public vj"r,
MV COMMISSION#FF 900342
=_'< �,•3; EXPIRES:November 16,2019
Bonded ThruNoGvyPublic Underwriters Personally Known OR [ J Produced Identification
Type of Identification:
Updated 10/17/18