1528 W Park Ter PLRS20-0016 4 Fixtures Bathroom Remodel ,:11-44-.,„t
:f- -.,„ PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
" PLRS20-0016
,
F) CITY OF ATLANTIC BEACH
K,„`"K,„`" r800 SEMINOLE ROAD ISSUED: 1/29/2020
\`4011j9 ATLANTIC BEACH. FL 32233 EXPIRES: 7/27/2020
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:
1528 W PARK TER PLUMBING RESIDENTIAL 4 FIXTURES FOR REMODEL $1250.00
BATHROOM
TYPE OF 1 REAL ESTATE BUILDING USE i
ZONING: SUBDIVISION:
CONSTRUCTION: i NUMBER: GROUP:
171939 0000 SELVA MARINA UNIT 02
COMPANY: ADDRESS: CITY: I STATE: ZIP:
ADVANTAGE PLUMBING 880 MAYPORT RD JACKSONVILLE FL 32240
BEACH
OWNER: ADDRESS: CITY: 1=1111 ZIP:
GHIOTTO PHILIP M 1528 PARK TER W ATLANTIC BEACH FL 32233-5535
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 4 $28.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$87.00
Issued Date: 1/29/2020 1 of 2
` PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
', 'f PLRS20-0016
)
CITY OF ATLANTIC BEACH
�r ISSUED: 1/29/2020
800 SEMINOLE ROAD
`�`=t 9r ATLANTIC BEACH, FL 32233 EXPIRES: 7/27/2020
Issued Date: 1/29/2020 2 of 2
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Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
31 800 Seminole Rd, Atlantic Beach, FL 32233 RCS
`riii SP" Phone: (904) 247-5 26 Email: Building-Dept@coab.us PERMIT#:o?Q —dcJJZ
4/i.JOB ADDRESS: ot, /) �f en PROJECT VALUE$ 4 VO•C/v
❑NEW OR REPLACEMENT INSTALLATION and/or CI RE-PIPE
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 _2_ Water Heater
Other Fixtures Water Treating System
LI MISCELLANEOUS
❑ 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: aLDdL 4 Phone Number:
Plumbing Company: C �.9jrmyp /Chi" Office Phone:��l Faxp
71r- 76.9/
Co. Address: -'6 (169/4,
(Q01 City: State:tr7 Zip: 3Z �3
License Holder: �' ' -7 vi5 State ertification/Registration# eyria�qs9
Notarized Signature of License Holder
The foregoing instrument was acknowledged before-K;this act day of Ja_Aut. " , 20 in the State of Florida,
County of .I()lkVrt)
Signature of Notary Public
JENNIFER JOHNSTON [4rsonally Known OR [ ] Pro uced Identification
- MY COMMISSION#GG 042984
; iwu *
EXPIRES:October 27,2020 Type of Identification:
'.FOF r : Bonded Thru Notary Public Underwriters Updated 10/17/18