1546 Ocean Blvd PLRS20-0160 Install 8 Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
.V PLRS20-0160
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 10/28/2020
ATLANTIC BEACH. FL 32233 EXPIRES: 4/26/2021
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.
JOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
hat may be found in the public records of this county, and there may be additional permits required from other
:overnmental entities such as water management districts, state agencies, or federal agencies.
JOB ADDRESS: PERMIT TYPE: I DESCRIPTION: VALUE OF WORK:
install 8 fixtures for interior
1546 OCEAN BLVD PLUMBING RESIDENTIAL remodel-kitchen, bath, $1500.00
doors
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171884 0000 MANDALAY
COMPANY: ADDRESS: CITY: STATE: ZIP:
STYLES SMITH PLUMBING 1537 PENMAN RD SUITE A JACKSONVILLE FL 32250
BEACH
OWNER: ADDRESS: CITY: STATE: ZIP:
CAMPBELL DONALD 1546 OCEAN BLVD ATLANTIC BEACH FL 32233
ROGERS
NARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT If`
'OUR 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
NTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
tECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
toll 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 8 $56.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
Issued Date: 10/28/2020 1 of 2
rS.:L�' .i,„ PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER I
C) PLRS20-0160
4`` ," CITY OF ATLANTIC BEACH
,� '4' 800 SEMINOLE ROAD ISSUED: 10/28/2020
�`01119ATLANTIC BEACH. FL 32233 EXPIRES: 4/26/2021
STATE DCA SURCHARGE 455-0000-208-0600 I 0 $2.00
TOTAL:$115.00
Issued Date:10/28/2020 2 of 2
U
D- 1roO
ter 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#: EZ ES ZO — O
JOB ADDRESS: 155LII0 OCQo.n 1Vd . PROJECT VALUE $ (5o0 - ° C)
✓DJEW OR REPLACEMENT INSTALLATION and/or ERE-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 _k__
Hose Bibs Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory I Water Heater _I
Other Fixtures Water Treating System
❑VIISCELLANEOUS
❑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 AV/1, ighLe_ a.741 o4 7O 66'5721=10 b0,7k i ragA2
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: O1). P . 101A.ct,(4 f2-ovis Phone Number: g04 -7o -9bb .0
Plumbing Company: SiAl k -S ti f)ut'Y\ki l.Office Phone: `/04i-a4I Fax /J tP--
Co. Address: 15 31 pea'\YY\oj-\ P.DoCk City:jGtyr' 1 &Ch State: FL_Zip: 32-26o
License Holder: [CS S,\A i'1..rN, State erjtification/Registration # CFGi1.123 'S2_
Notarized Signature of License Holder t
().
The foregoing instrument was acknowledged before me this �.'r� day of OL,t0e,-- , 201 , in the State of Florida,
County of meq\
Signature of Notary Public 4AArs>tkakA L k_Q
SWEENEY
• • • _•. ,` °ri14 ( [q/Personally Known OR [ ] Produced Identification
b.2022 Type entifIcation.
.•••.• r. .r for %a:my Assn. I
oi•04:, STEPHANIE M SWEENEY (' Updated 10/17/18
f; Notary Public.State of Florida
*44 Commission B GG 250641
orrrr.Expires Oct 5,2022
60c(!tC tnruugh National Notary Assn.