1460 Beach Ave PLRS19-0232 1 Fixture for Covered Pergola c�="''` PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS19-0232
� , �, CITY OF ATLANTIC BEACH ISSUED: 12/20/2019
800 SEMINOLE ROAD
'f ir ATLANTIC BEACH, FL 32233 EXPIRES: 6/17/2020 1
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:
1460 BEACH AVE PLUMBING RESIDENTIAL 1 FIXTURE FOR COVERED $600.00
PERGOLA
TYPE OF REAL ESTATE ZONING: + BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171863 0000 MANDALAY
COMPANY: ADDRESS: CITY: STATE: ZIP:
MARCHAND PLUMBING 10139 BOOKWOOD FOREST BLVD JACKSONVILLE FL 32225
INC.
OWNER: ADDRESS: , CITY: ! STATE: ZIP:
EDSALL RANDY D 1460 BEACH AVE ATLANTIC BEACH FL 32233-5734
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.
d
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 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 1 $7.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$66.00
Issued Date: 12/20/2019 1 of 2
I
.Ir PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
` CITY OF ATLANTIC BEACH PLRS19-0232
)1800 SEMINOLE ROAD ISSUED: 12/20/2019
1.ort 9r ATLANTIC BEACH, FL 32233 EXPIRES: 6/17/2020
Issued Date: 12/20/2019 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 t,
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: P LIZS G -0a'
JOB ADDRESS: //O ileetc i /¢VK PROJECT VALUE $ (. -v°
❑NEW OR REPLACEMENT INSTALLATION and/or EIRE-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 1, Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS
i Sewer Replacement
Back Flow Preventer
-I Lawn Sprinkler System (number of sprinkler heads)
i Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
LI 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: .'b ( J 1C016.15 Phone Number:
•,:/.;
Company: z�� P� � � tiG Office Phone: 4 -5-155 Fax
Co. Address: X013 xo wc:occc)1tz4 0VCity: JCQx State:f l Zip: `. 395
License Holder: (ec-c'tQ, P I- State Certification/Registration # CFC.05-1365
Notarized Signature of License Holder VII
•
The foregoingkstrument was acknowledged before me this • day of Dai* , in the State of Florida,
County of ULAVC1
'Gild&
SP1 P
Signature of Notary PublicUAL teo_.Q
nni.'•. MICHELLE BEAL
47..i..t,; Commission#GG 294859
s o= Expires February 18,2023 [ 1 Personally Known OR ProdWced Identification
Bonded Thu Troy Fain insurance 806.385-7019 Type of Identification: .-- VVIIS (, CiY S -P —
Updated 10/17/18