1830 Seminole Rd PLRS20-0008 3 Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS20-0008
CITY OF ATLANTIC BEACH
� :u v 800 SEMINOLE ROAD ISSUED: 1/16/2020
ATLANTIC BEACH. FL 32233 EXPIRES: 7/14/2020
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:
1830 SEMINOLE RD PLUMBING RESIDENTIAL PLUMBING - 3 FIXTURES $1200.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0510 SELVA MARINA UNIT 09
COMPANY: ADDRESS: CITY: STATE: ZIP:
ADVANTAGE PLUMBING 880 MAYPORT RD JACKSONVILLE FL 32240
BEACH
OWNER: ADDRESS: I CITY: STATE: ZIP:
ANDREW BRYANT 1830 SEMINOLE RD ATLANTIC BEACH FL 32233
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 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $80.00
Issued Date: 1/16/2020 1 of 2
rt'yL"' PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
a PLRS20-0008
• CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 1/16/2020
ATLANTIC BEACH. FL 32233 EXPIRES: 7/14/2020
Issued Date: 1/16/2020 2 of 2
„org74,„ Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
,4 City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 125
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: ^ (D j7
JOB ADDRESS: I `3(9 Sep1/N /' PROJECT VALUE $ 4100e m
OWE
✓ANEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE p �Sz `
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 —� Vacuum Breakers
Laundry Tray Water Connected Appliances /
Lavatory Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS 72)
['Sewer Replacement
❑Back Flow Preventer
❑Lawn Sprinkler System (number of sprinkler heads)
D3rease Interceptor (Trap) gallons (Requires 3 sets of plans)
0 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: Il-MJ L3,Q/4 I'I Phone Number: � - Ens”
Plumbing Company: f9//t/ij474,14 /"ern/ / Office Phone: 7/7-y8 Fax/77 99q/
Co. Address:
ego "9vfr,/ City: 4'/_f3 State:*Zip: :�� 3j
License Holder: C...94 U 4.t. e Certification/Registration # Cj C' A.2�7S9
Notarized Signature of License Holder - /
The forego' strumen was acknowledged befor- • e this I�,� da o GZy1 , 20 n the State of Florida,
County of l __'C)
I
Signature of Notary Public,-- ti -
Y TONI GINDLESPERGER
MYCOMMISSION#GG353178 [ 1 Personally Known OR [ ] Produced Identification
a. :,� EXPIRES:October6.2023 Type of Identification:
%-f:21,;0,' Bonded Thru Notary Put*Underwriters
Updated 10/17/18
iy-
,J .,. � Cash Register Receipt Receipt Number
V r City of Atlantic Beach R11662
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $55.00
PLRS20-0008 Address: 1830 SEMINOLE RD APN: 172020 0510 $55.00
PLUMBING ROUGH 02/05/2020 RBE $55.00
PLUMBING ROUGH 02/05/2020 RBE 455-0000-322-1002 0 $55.00
TOTAL FEES PAID BY RECEIPT: R11662 $55.00
Date Paid: Wednesday, February 05, 2020
Paid By: ADVANTAGE PLUMBING
Cashier: CT
Pay Method: CREDIT CARD 14
Printed: Wednesday, February 05, 2020 3:40 PM 1 of 1
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