307 Ahern St PLRS19-0179 21 Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
'S
rPLRS19-0179
CITY OF ATLANTIC BEACH
J V 800 SEMINOLE ROAD ISSUED: 9/23/2019
»r ATLANTIC BEACH. FL 32233 EXPIRES: 3/21/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, ' OF • 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:
307 AHERN ST PLUMBING RESIDENTIAL PLUMBING - 21 FIXTURES $8000.00
TYPE OF
• i • '
169737 0010 ATLANTIC BEACH
COMPANY: ADDRESS:
NELSON PLUMBING CO. 11624 -1 DAVIS CREEK ROAD EAST JACKSONVILLE FL 32256
INC.
OWNER: ADDRESS:
AHERN TH PROJECT LLC 830 13 A1A N 4120 PONTE VEDRA Fl 32082
BEACH
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 CONDITIONS
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 4S5-0000-322-1000 0 $0.00
PLUMBING FIXTURES 4SS-0000-322-1000 21 $147.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $3.03
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.02
Issued Date: 9/23/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0179
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 9/23/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 3/21/2020
TOTAL: $207.05
Issued Date: 9/23/2019 2 of 2
Plumbing Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 P L..R'S 19 Di 7
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: ZeS 17 — 0266
JOB ADDRESS: ; o-7 A-meg.hj iE 1 PROJECT VALUE $ o0d' OJ
EW OR REPLACEMENT INSTALLATION and/or ❑RE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer 1 Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs Z, Urinal
Kitchen Sink _� Vacuum Breakers
Laundry Tray Water Connected Appliances Z
Lavatory _ ater Heater
Other Fixtures \ ater 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: Phone Number:
Plumbing Company:/✓e15P.✓ A640II„AQ �r Office Phone: 7-62- • Y VB Fax
Co. Address: '2 �11/1� �2! t � C- 4)L- State: "(,.Zip:
License Holder: c — /Vt J i ation/Registration #
Notarized Signature of License Holder
The foregoi trumen was acknowledged before me this day of 206 in the State of Florida,
County of
LISA BASS Signature of Notary Public J �
aa41' Ons
.; MY COMMISSION#FF 930342
EXPIRES:November 16,2019 [ Personally Known OR [ ] Produced Identification
'?o'n, Bonded Thu Notary Public UnderwMers
Type of Identification:
Updated 10/17/18