1242 Beach Ave PLRS20-0015 plbg permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
� CITY OF ATLANTIC BEACH PLRS20-0015
0
ISSUED: 1/29/2020
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233 EXPIRES: 7/27/2020
MUST CALL INSPECTION PHONE914BY , PM FORDAY 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 . . 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.
�
i-JOB A• • • DESCRIPTION: VALUE OF • •I'I
1242 BEACH AVE PLUMBING RESIDENTIAL PLUMBING - 9 FIXTURES $2000.00
TYPE OF •
ZONING: : • •
• • GROUP:
171828 0000 MANDALAY
COMPANY: • • • • STATE:
Duval Plumbing 5760 Mining Terrace Jacksonville FI 32257
• ADDRESS:
IL
KING JOHN ANTHONY 1242 BEACH AVE 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 • .
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
PLUMBING FIXTURES 455-0000-322-1000 9 $63.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$122.00
Issued Date: 1/29/2020 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS20-0015
_. CITY OF ATLANTIC BEACH 0
800 SEMINOLE ROAD ISSUED: 1/29/202
ATLANTIC BEACH, FL 32233 EXPIRES: 7/27/2020
Issued Date: 1/29/2020 2 of 2
Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
fV City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 hL2SL0-- Cwt S
Phone: (904) 247-5826 Email: Building-Dept@coab.u{ PLRMIT#: ROH-036-1
JOB ADDRESS: A's• I Ai\z6'NL_ SqQ SS PROJECT VALUE $ (C)t�
�VEW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE
TYPE OF FIXTURE QTY TYPE_ OF FIXTURE QTY
Bathtub 1 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
CMISCELLANEOUS
❑Sewer Replacement
❑Back 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:_ r\\O��a�(1 I,� _ Phone Number: q04 -3q3-1<05j i
Plumbing Company: tu,�flk ?kkjm� ;n1 :J c Office Phone: %L+- 3-'1991 Fax
Co. Address: \ �j � 0`J�X�1'1S �d City: JpState: Zip:
License Holder: ol.�Ia�,! i'�t`-74 State Certrt icati /Registration t! C FC [LtQ 9893
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this2 day of444, - 2&) in the State of Florida,
County of Nativ \�
M>LOt)Y L.DEMPSEY j
Signat of Notary Publib. / )
MY COMMItdN GG 2594
plembet 17.2022
•: EYPIKES: Full_ Ucxses w s
[ Personally Known OR [ J Produce Identification
Type of Identification:
Updated 10/17118
:JS
RegisterCash • •
Receipt
City of • •
DESCRIPTION ACC• CITY PAID
PermitTRAK $122.00
PLRS20-0015 Address: 1242 BEACH AVE APN: 171828 0000 $122.00
PLUMBING $118.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 9 $63.00
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 . R11579 $ 11
Date Paid: Wednesday,January 29, 2020
Paid By: Duval Plumbing
Cashier: LE
Pay Method: CREDIT CARD 1
Printed:Wednesday,January 29,2020 10:37 AM 1 of 1 It
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