1325 Beach Ave PLRS21-0010 Permit PacketOWNER:ADDRESS:CITY:STATE:ZIP:
LAMBROU FRED H JR &
ANDREWS PATRICIA D 1863 RIVER RD JACKSONVILLE FL 32207
COMPANY:ADDRESS:CITY:STATE:ZIP:
J WHITEHEAD PLUMBING
INC 125 DIEGO ISLAND CT ST. AUGUSTINE FL 32095
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170297 0000 ATLANTIC BEACH
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1325 BEACH AVE PLUMBING RESIDENTIAL PLUMBING - 14 FIXTURES $2500.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 14 $98.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.30
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $157.30
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: 1/21/2021
PERMIT NUMBER
PLRS21-0010
ISSUED: 1/21/2021
EXPIRES: 7/20/2021
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 1/21/2021
PERMIT NUMBER
PLRS21-0010
ISSUED: 1/21/2021
EXPIRES: 7/20/2021
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $157.30
PLRS21-0010 Address: 1325 BEACH AVE APN: 170297 0000 $157.30
PLUMBING $153.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 14 $98.00
STATE SURCHARGES $4.30
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.30
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R14652 $157.30
Printed: Thursday, January 21, 2021 8:33 AM
Date Paid: Thursday, January 21, 2021
Paid By: J WHITEHEAD PLUMBING INC
Pay Method: CREDIT CARD 415583039
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R14652
Plumbing Permit Application ALL INFORMATION
HIGHLIGHTED IN
ii ')• City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 PLR -Z. ( — Co I 0isEY
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS:ISQVIA 't-"v PROJECT VALUE $/PAO .
7.,_0-014
NEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan 2
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory It Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS
Sewer Replacement 14
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: hvVrtil1"J V 4I,l Phone Number: cirft-m—(05(ci,
Plumbing Company: WthAV / Office Phone: orot_%-rir-dd, Fax
Co. Address: l . syv t F I
City: Cr Ak\ State:' Zip: ?iti6
License Holder: i A.,v,a4AI State Certification/Registration #
Notarized Signature of License H. der
The forego) strumennt w s acknowledged before me this (
c-1d of, 0./A , 2I?--- (, in the State of Florida,
County of UV 1
Signature of Notary Public.- c
o'•RC•P• . TONI G:NDLESPERGER Personally Known OR [ ] Prodyced Identification
MY COMMISSION#GG 353178
74.-...,;:z77. EXP,RES:October 6,2023
Type of Identification: J
onded Thru Notary Public Underwriters Updated 10/17/18