1330 Ocean Boulevard PLRS20-0004 Garage ';'. `...PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
S ��� PLRS20-0004
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ISSUED: 1/9/2020
!u;3i.9% EXPIRES: 7/7/2020
ATLANTIC BEACH. FL 32233 .J
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:
1330 OCEAN BLVD PLUMBING RESIDENTIAL GARAGE TOOK OVER $0.00
PLRS19-0172
TYPE OF REAL ESTATE ZONING: BUILDING USE • SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171847 0000 MANDALAY
COMPANY: ADDRESS: CITY: i STATE: , ZIP:
DUVAL CONSTRUCTION
INC 13221 Mendenhall PI JACKSONVILLE FL 32224
OWNER: i ADDRESS: CITY: I_ STATE: ZIP:
ROBERT EBENER 1330 OCEAN BLVD ATLANTIC BEACH Fl 32233-5744
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.
— — —
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 0 $0.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455 0000-208-0600 0 $2.00
TOTAL: $59.00
Issued Date: 1/9/2020 1 of 1
rs`11.I.0, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
c;;.*� J` PLRS20-0004
�r, .,- s? CITY OF ATLANTIC BEACH
my ISSUED: 1/9/2020
800 SEMINOLE ROAD
`' ;is>',' ATLANTIC BEACH. FL 32233 EXPIRES: 7/7/2020
Issued Date: 1/9/2020 2 of 2
PlumbingPermit Application **ALL INFORMATION
Mp HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 PL .5Z -coo 4
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:/
JOB ADDRESS: l3 --k) 26.--L PROJECT VALUE $ /
Li NEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE a CIN p%1 e r P L RS . 9 _OI7Z
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 2 Urinal
Kitchen Sink �_ Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater �—
Other Fixtures Water Treating System
❑MISCELLANEOUS
u Sewer Replacement
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler heads)
n Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
E Well **SJRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.**
n 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:2/) /� -f' 3Eie/ , 2 Phone Number: 90--/-7/e9 3 74
Plumbing Companv:D4/42.- (e2A-5 7O4' Office Phone: 8487-- .3' Fax
Co. Address: /32 '/ OG City: ,414,--", State: Zip: i
License Holder:/ ,42- #1' ?„ 16, CAA ' State Certific ion/Registration# �Yz- �'f c9 22
�Notarized Signature of License Holder
The foregoi strument as acknowledged before me this •. ca.C\ , 20Z n the State of Florida,
County of Vet.,
Signature of Notary Pubic It aft. !/,
[ ] Personally Known OR [ 1 Produced Identification
Type of Identification:
. ..... •'' i` LE`:PERGER
oh 1.1 MY COMr.MlSslo14-0 **17
p �E� PIXPIRES:October 6,2023
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