1812 Sea Oats Dr PLRS19-0203 Bath Remodel f. t...,\,,,,, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0203
CITY OF ATLANTIC BEACH ISSUED: 10/30/2019
800 SEMINOLE ROAD
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-'�;" ATLANTIC BEACH. FL 32233 EXPIRES: 4/27/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA 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:
1812 SEA OATS DR PLUMBING RESIDENTIAL BATH REMODEL 3 $4000.00
FIXTURES
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0562 SELVA MARINA UNIT 09
COMPANY: ADDRESS: CITY: STATE: ZIP:
BROOKSHIRE PLUMBING 3555 BOWDEN CIR W JACKSONVILLE FL 32216
OWNER: ADDRESS: CITY: STATE: ZIP:
WARNOCK HARVEY K LIFE 301 1ST ST ATLANTIC BEACH FL 32233
ESTATE
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.
FEES
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 $2.79
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 10/30/2019 1 of 2
CPERMF PLUMBING RESIDENTIAL PERMIT
IT NUMBER
�, CITY OF ATLANTIC BEACH PLRS19-0203
R 800 SEMINOLE ROAD ISSUED: 10/30/2019
j ATLANTIC BEACH. FL 32233 EXPIRES: 4/27/2020
WORK WITHOUT PERMIT 455-0000-322-1000 0 $110.00
TOTAL:$190.79
Issued Date: 10/30/2019 2 of 2
r . Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
'\ City of Atlantic Beach Building Department GRAY IS REQUIRED.
r,
c800 Seminole Rd, Atlantic Beach, FL 32233 f 7Lj< (`-i - u .C)3
,��;:"" Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: I (6 ( Z S e c, D 21- S if PROJECT VALUE $ 7 Z`bO. )O
El 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 _i_
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet --1--
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory _/__— Water Heater
Other Fixtures Water Treating System
III MISCELLANEOUS v J
Li Sewer Replacement
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler heads)
❑ Grease Interceptor(Trap) gallons (Requires 3 sets of plans)
E Well **SIRWD 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.
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Owner Name: 114/`i)e--- - fr ►.-NJ arr-SDI_- IC Phone Number: 6;31 .3g0
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Plumbing Company: ' -Cni N,c71,ll Office Phone.`W ) 3'Z-gz7Fax --s
Co. Address: 35" , a cl ef2e---) C • f v-) City: -Y:tp.k...5t),, '41(142-State: Zip: .3 z( 4,
License Holder: .eci LQr i...Skt ee, State Certification/Registration # LCZ._/ `y _C.3-13
Notarized Signature of License Holder A,./. / I ' •
The foregoi strument upas acknowledged before me this. --fay 20C- , in the State of Florida,
County of 0/C),_t,
Signature of Notary PublicCk C-74'_,, —)
.;;AY►i ;, TONIGINDLESPERGER [ ] Personally Known OR I Produced Identification
'' : my
S GG 353178 - Z i�
_ •,L. EMIRES:October 6,2023
Type of Identification: (c,ZCo Z. Ci L, �.
'�'Fo�°�' Bonded f1Yu Notely PLtIC UndgwlMe�$ Updated 10/17/18