460 Whiting Ln PLRS20-0178 12 Fixtures %S' '' ' PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
"- �''� CITY OF ATLANTIC BEACH PLRS20-0178
ISSUED: 12/10/2020
_ 800 SEMINOLE ROAD EXPIRES: 6/8/2021
JR19%' ATLANTIC BEACH. FL 32233
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: DESCRIPTION: VALUE OF WORK:
460 WHITING LN PLUMBING RESIDENTIAL RE-PIPE 12 FIXTURES $1975.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171451 0000 ROYAL PALMS UNIT
02A3.00
COMPANY: ADDRESS: CITY: STATE: ZIP:
ADVANTAGE PLUMBING 880 MAYPORT RD JACKSONVILLE FL 32240
BEACH
OWNER: I ADDRESS: CITY: STATE: ZIP:
FORSYTH V ALLISON 1738 SELVA MARINA DR ATLANTIC BEACH FL 32233-5436
NARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT I(`
'OUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT
JIUST 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
ECORDING YOUR NOTICE OF COMMENCEMENT.
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 12 $84.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.09
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$143.09
Issued Date: 12/10/2020 1 of 2
,;,S\----'Yl%� , PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS20-0178
��_ i CITY OF ATLANTIC BEACH ISSUED: 12/10/2020
800 SEMINOLE ROA
,,=�-_—__ , EXPIRES: 6/8/2021
ATLANTIC BEACH, FL 32233
Issued Date:12/10/2020 2 of 2
rS�1�f i ,- ilk� Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
c� City of Atlantic Beach Building Department GRAY IS REQUIRED.
`' 800 Seminole Rd, Atlantic Beach, FL 32233 7 L R SaO —U i 7 5
`J`t'r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: /&/ABY//Jy /Ai PROJECT VALUE $ /9 7S-�
✓❑NEW OR REPLACEMENT INSTALLATION and/or ARE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub a Septic Tank & Pit
Clothes Washer I Shower
Dishwasher I Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet j
Hose Bibs .2 Urinal
Kitchen Sink i Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory ,3 Water Heater /
Other Fixtures ' Water Treating System
DV1ISCELLANEOUS i\,
❑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: /9l/SPA) / sy7he Phone Number: 7)4 ' ? 2f7
Plumbing Company: I7,o vo.A7/) /0/U413j&19 Office Phone: ,P47' Cf-d`y( Fax
Co. Address: &K0 /-)2/ �, ,�(/ City: 8cL, State: ` 3 Zip: 77Z_/
� id/ / j•7.
License Holder. _ ,�_ - ' - State C rtification/Registration # e/ 'J {-g57
Notarized Signature of License Holder :4 , azo2 e_
The foregoin rument as acknowledged before m his/0 day 1C-' C . , 204')n the State of Florida,
County of 0 _
�.�..��... Signature of Notary Public! 4��.
4rP1e':,: TONI GINDLESPERGER
, ia ':,: MY COMMISSION#GG 353178 [ ] rsonally Known OR [ ] Produced Identification
1)-=.':;;,.. ��.P EXPIRES:October 6,2023
GI •••AFF;°'' BondedThruNotary Public Underwriters Type of Identification:
Updated 10/17/18