51 Forrestal Cir PLRS20-0109 17 FixturesOWNER:ADDRESS:CITY:STATE:ZIP:
MICHAEL HEDGE 2462 RIDGE WILL DRIVE JACKSONVILLE FL 32246
COMPANY:ADDRESS:CITY:STATE:ZIP:
DON HARRIS PLUMBING,
LLC 4029 BLANDING BLVD JACKSONVILLE FL 32210
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171738 0000 ATLANTIC BEACH VILLA
# 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
51 FORRESTAL CIR PLUMBING RESIDENTIAL PLUMBING - 17 FIXTURES $18000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 17 $119.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.61
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $178.61
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 7/28/2020
PERMIT NUMBER
PLRS20-0109
ISSUED: 7/28/2020
EXPIRES: 1/24/2021
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 7/28/2020
PERMIT NUMBER
PLRS20-0109
ISSUED: 7/28/2020
EXPIRES: 1/24/2021
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $178.61
PLRS20-0109 Address: 51 FORRESTAL CIR APN: 171738 0000 $178.61
PLUMBING $174.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 17 $119.00
STATE SURCHARGES $4.61
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.61
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R12442 $178.61
Printed: Tuesday, July 28, 2020 2:15 PM
Date Paid: Tuesday, July 28, 2020
Paid By: DON HARRIS PLUMBING, LLC
Pay Method: CREDIT CARD 348718182
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R12442
Plumbing Permit Application
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us
**ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
PERMIT #: ______ _
JOB ADDRESS: 51 FORRESTAL CIR PROJECT VALUE $_18 .... ~_00_._-_____ _
0\lEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE
Bathtub
Clothes Washer
Dishwasher
Drinking Fountain
Floor Drain
Floor Sink
Hose Bibs
Kitchen Sink
Laundry Tray
Lavatory
Other Fixtures
DVIISCELLANEOUS
DSewer Replacement
DBack Flow Preventer
QTY
2
2
4
TYPE OF FIXTURE
Septic Tank & Pit
Shower
Shower Pan
Slop Sink
Three Compartment Sink
Toilet
Urinal
Vacuum Breakers
QTY
3
Water Connected Appliances _1 __
Water Heater 1 ---
Water Treating System
o Lawn Sprinkler System (number of sprinkler heads) __ _
OJrease Interceptor (Trap) gallons (Requires 3 sets of plans)
DWell *. 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:MICHAEL & PAIGE HEDGE Phone Number: _________ _
Plumbing Company : DON HARRIS PLUMBING LLC Office Phone: (904) 772-0900 Fax(904) 779-2388
Co. Address: 4029 BLANDING BLVD City: JACKSONVILLE State: ~ Zip : _32_2_1_0 __ _
License Holder: MARK L. WOLLITZ State Certification/Registration # CFC056486
Notarized Signature of License Holder _".A~~~~~~~~G~==== _____________ _
The fOr e gO ~strument was acknowledged before
County of vIII"
_ +--=-........,~---' 20~n the State of Florida,
Signature of Notary Publicl-IP-LJ-L;'-'-----". ...... ~~""""'~ .................... _______ _
[M ersonally Known OR [ ] (y~ of Identification: ____________________ _
.. t*~w··.,.. KIM BUTLER
l· .... ·tlr. ';.~ ~ Commission # GG 118883
~:'~:~~~l Exp ires Octob er 25 , 2021 '!:;f,~r.f.;~;.,. Bond odihru Troy Fain InsuranC1l 800·38&-7019
Updated 10/17/18