303 Ahern St PLRS19-0234 23 Fixtures ,;11.-,v1.-ii,, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
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CITY OF ATLANTIC BEACH PLRS19-0234
�r �� 800 SEMINOLE ROAD ISSUED: 12/23/2019
EXPIRES: 6/20/2020
ATLANTIC BEACH. FL 32233 I
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:
303 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: i STATE: M
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.
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 23 $161.00
STATE DBPR SURCHARGE 455-0000-208 0700 0 $3.24
i
STATE DCA SURCHARGE 455 0000-208-0600 0 $2.16
TOTAL: $221.40
Issued Date: 12/23/2019 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0234
800 SEMINOLE ROAD ISSUED: 12/23/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 6/20/2020
Issued Date: 12/23/2019 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 Pb R� ( l -02.34
Phone: (904)
247-5826 Email: Building-Dept@coab.us PERMIT#: 2_63 17 - 02_70
JOB ADDRESS: 3 D 3 A+I(,� ,c7-- PROJECT VALUE $ 9con
klEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank& Pit
Clothes Washer I Shower I
Dishwasher I Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs 3 Urinal
Kitchen Sink Vacuum Breakers ___3__
Laundry Tray I Water Connected Appliances 1
Lavatory Water Heater r
Other Fixtures Water Treating System I
❑V1ISCELLANEOUS /) ��
OSewer Replacement �/
DBack 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: A f(E9,./ To►vo l/ko Wve-s Phone Number:
Plumbing Company: /N&ISt)v' R1/4.4/11 eo J wt_ Office Phone: 7,t 2 . q a Fax
Co. Address: 14,7q - l )f / s 0/644-iO V� City: ,3 Asp State: (L Zip: 3-2-256
License Holder: v ( d _i.►' A /S :t•j ert• ication/Registration# C72,0 3`1 g'
— 00.9.
Notarized Signature of License Holder iI 10
The foregoi • strument as acknowledged before me this 'G day of-120 l9, in the State of Florida,
County of n
Signature of NotaryPubli ! ' ge,,,,
g
.o��r^6� LISA P BASS
?/.(�` Notary Public•State of Florida
1 , ,,,11/4,,.. y 1 [ - ersonally Known OR [ ] Prod ed Identification
� 3 Commission#GG 910213
''horn My Comm.Expires Nov 16,2023 ► Type of Identification:
1 Bonded through National Notary Assn.
Updated 10/17/18