2219 W Oceanwalk Dr PLRS20-0011 2 Fixtures ''''r PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
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, CITY OF ATSEMINOLE LANTICROAD BEACH PLRS20-0011
800
ISSUED: 1/24/2020
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0109., ATLANTIC BEACH. FL 32233 EXPIRES: 7/22/2020
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:
2219 W OCEAN WALK DR PLUMBING RESIDENTIAL PLUMBING - 2 FIXTURES $1000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169463 0546 OCEAN WALK UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
HARRY L HAYES PLUMBING 130 ARLINGTON RD S JACKSONVILLE FL 32216
INC
OWNER: ADDRESS: CITY: STATE: ZIP:
RATHET BROOKS C & BETH 2219 OCEAN WALK DR W ATLANTIC BEACH FL 32233-4576
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.
I
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 2 $14.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $73.00
Issued Date: 1/24/2020 1 of 2
(c-----.0.A.N PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
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CITY OF ATLANTIC BEACH PLRS20-0011
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800 SEMINOLE ROAD
ISSUED: 1/24/2020
�t`�'; �r ATLANTIC BEACH. FL 32233 EXPIRES: 7/22/2020
Issued Date: 1/24/2020 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
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:RESfat•
JOB ADDRESS: 2219 West Oceanwalk Drive 32233 PROJECT VALUE $1,000.00
✓dJEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher 1 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 \l Water Treating System
D'/1ISCELLANEOUS
Sewer Replacement
❑Back Flow Preventer
❑Lawn Sprinkler System (number of sprinkler heads)
grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑Well ••SIRWD 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:Rathet Phone Number: (904)608-0296
Plumbing Company: Harry L Hayes Plumbing, Inc Office Phone: (904)723-5609 Fax(904)329-4325
Co. Address: 130 Arlington Road South City: Jacksonville State: Fl Zip: 32216
License Holder: Harry Hayes State Certification/Registration # CFC1427058
Notarized Signature of License Holder--- \ —
J
The foregoing instrument was acknowledged before me this jt-i day of JCi.rt ,20?V, in the State of Florida,
County of \t-)
Signature of Notary Public Of-Z.4,3
`flj 11,,„„(.3--)
o�?y.rnoy Notary Public State of Florida [ rsonally Known OR [ ] Produced Identification
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F Lindsey N.Moony
s My Commission GG 110673 Type of Identification: INl ' ]'v
y�or rsd" Expires 06/01/2021
Updated 10/17/18
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Cash Register Receipt Receipt Number
�Or•(i--y....tv,,,,r4
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tAfCity of Atlantic Beach R11544
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o;32
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DESCRIPTION ACCOUNT QTY I PAID
PermitTRAK $73.00
PLRS20-0011 Address: 2219 W OCEANWALK DR APN: 169463 0546 $73.00
PLUMBING $69.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 2 $14.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R11544 $73.00
Date Paid: Friday, January 24, 2020
Paid By: HARRY L HAYES PLUMBING INC
Cashier: CT
Pay Method: CREDIT CARD 024924
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Printed: Friday,January 24, 2020 10:47 AM 1 of 1 14