305 Ahern St PLRS19-0233 23 Fixtures ,',1'" PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
b. `� ""j CITY OF ATLANTIC BEACH PLRS19-0233
OP800 SEMINOLE ROAD ISSUED: 12/23/2019
1,,,;t'�— EXPIRES: 6/20/2020
ATLANTIC BEACH. FL 32233
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:
305 AHERN ST PLUMBING RESIDENTIAL PLUMBING - 23 FIXTURES $8000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169737 0010 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
NELSON PLUMBING CO. 11624 -1 DAVIS CREEK ROAD EAST JACKSONVILLE FL 32256
INC.
OWNER: ADDRESS: CITY: STATE: ZIP:
AHERN TH PROJECT LLC 830 13 A1A N #120 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.
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
L_
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 23 $161.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.24
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.16
Issued Date: 12/23/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0233
e ir.
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800 SEMINOLE ROAD ISSUED: 12/23/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 6/20/2020
TOTAL:$221.40
Issued Date. 12/23/2019 2 of 2
Plumbing Permit Application **ALL INFORMATION
HIGHL►GHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
Y 800 Seminole Rd, Atlantic Beach, FL 32233 PLR 3 1 9 —O2-35
f Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 128-,V7 S7 — OZ YI
JOB ADDRESS: t9 S /0 tiVIA) Cr PROJECT VALUE$ .v ODD
EW OR REPLACEMENT INSTALLATION and/or ❑RE-PIPE
l!l111114
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank & Pit
Clothes Washer __I___ Shower _L-_
Dishwasher I Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs 3 Urinal
Kitchen Sink --4-- Vacuum Breakers 3
Laundry Tray —1-_ Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System _1.__
DV1ISCELLANEOUS
OSewer Replacement
❑Back Flow Preventer
D 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: lIei2j' TOwea Home's Phone Number:
Plumbing Company: /l/SS'..., WGH„+,fS' 'G 6 J'NLOffice Phone: 262 , l 90 y Fax
Co. Address: II bi'1 -( OA-6J Caeret. Ct._ d 1. City: 1 .)c State: A_Zip: ,22,1-1,
License Holder: too 7-7- A/et-t c % / :t. =/ ■. . - ••n/Registration# 0 Z-C7-3 7 9
Ad 5,, ,_._.....,.-..:,......-auirrp.--
Notarized Signature of License Holder ir
i
The foregoi "nstrum�e rot was acknowledged before me this /(e day of t��I; , 20 l ;'in the State of Florida,
nei..k)
County of JU.) .J�
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Signature of Notary Public .
r a LISA P BASS i
• .I
,,..\,..(f,, Notary Public-State of Florida I [ ersonally Known OR [ ] Prod ced Identification
• c`r Commission z GG 910213
''')'a� ` My Comm.Expires Nov 16.2023 i Type of Identification:
Sanded through National Notary Assn.
• Updated 10/17/18