1505 E PARK TER - PLRS20-0057 ti-r.---r%, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
J !illI \S'\
�'"~ CITY OF ATLANTIC BEACH PLRS20-0057
�V_ 1, 800 SEMINOLE ROAD ISSUED: 3/18/2020
\or:i.9',' ATLANTIC BEACH. FL 32233 EXPIRES: 9/14/2020
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:
1505 E PARK TER PLUMBING RESIDENTIAL BATH ROOM PLUMBING - 5 $300.00
FIXTURES
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171951 0000 SELVA MARINA UNIT 02
COMPANY: i ADDRESS: CITY: STATE: ZIP:
COUF PLUMBING LARRY 1104 Wood Hill PL JACKSONVILLE FL 32256
COUF
OWNER: ADDRESS: CITY: STATE: ZIP:
ANDREWS DAVID B 1505 PARK TER E 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
jRoll off container company must be on City approved list . Container cannot be placed on City right-of-way.
,i _ ca'r,
•
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 5 $35.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 3/18/2020 1 of 2
PlumbingPermit Application **ALL INFORMATION
pp HIGHLIGHTED IN
tt. 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#:_
JOB ADDRESS: 1505 Park Terrace E, Atlantic Beach, FL 32233 PROJECT VALUE $300.00
alEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 1 Septic Tank& Pit
Clothes Washer Shower 1
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 1
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 2 Water Heater
Other Fixtures Water Treating System
CMISCELLANEOUS
❑Sewer Replacement
OBack Flow Preventer
❑Lawn Sprinkler System (number of sprinkler heads)
grease Interceptor (Trap) gallons (Requires 3 sets of plans)
O Well **SJRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.**
DOther
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:Larry Couf Phone Number: (904)899-3348
Plumbing Company: Couf Enterprise, LLC Office Phone: (904)516-7744 Fax
Co. Address: 6110-7 Powers Avenue City: Jacksonville State: FI Zip: 32217
License Holder: Larry Couf State Certification/Registration # CFC1429147
Notarized Signature of License Holder rz
The foregoillinstrument was ack • ed •- •re - this I $ day of I ( , 2Q�� in the State of Florida,
County of 17\,1vc
Signature of Notary Publi
�JY� SUMMER M DUNN
itj'. Notary Public-State of Fionca
1;l,-,,,a/1Commission x GG 934734 ['Personally Known OR [ ] Produced Identification
••-? d' My Comm.Expires Nov 25.2023
Sonoed through Nations,Nc a^r.4s, • Type of Identification:
Updated 10/17/18
(:,:f : `ljlJ
.40
' Cash Register Receipt Receiptt Number
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City of Atlantic Beach R12017
DESCRIPTION ( ACCOUNT I QTY PAID
PermitTRAK $181.00
PLRS20-0055 Address: 645 AQUATIC DR APN: 171818 5360 $87.00
PLUMBING $83.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 4 $28.00
STATE SURCHARGES
$4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
PLRS20-0057 Address: 1505 E PARK TER APN: 171951 0000 $94.00
PLUMBING $90.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
•
PLUMBING FIXTURES 455-0000-322-1000 5 $35.00
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: R12017 $181.00
Date Paid: Wednesday, March 18, 2020
Paid By: COUF PLUMBING LARRY COUF
Cashier: FJ
Pay Method: CREDIT CARD 10
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Printed:Wednesday, March 18,2020 3:03 PM 1 of 1