1707 Beach Ave PLRS21-0069 Plumb 20 Fixtures ro*
ri'"''% PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS21-0069
J 800 SEMINOLE ROAD ISSUED: 4/22/2021
'';�}r V ATLANTIC BEACH. FL 32233 EXPIRES: 10/19/2021
`
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.
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:
Plumb 20 Fixtures KTCHN &
1707 BEACH AVE PLUMBING RESIDENTIAL BATH $8000.00
REMODEL,DECK,SIDING &
WINDOWS
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169660 0000 NORTH ATLANTIC BCH
UNIT 1
COMPANY: ADDRESS: CITY: STATE: ZIP:
TDG PLUMBING 4426 LOYS DR JACKSONVILLE FL 32246
OWNER: ADDRESS: CITY: STATE: ZIP:
MALLOY JENNIE S 1707 BEACH AVE ATLANTIC BEACH FL 32233-5838
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT If\
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
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
FEES
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 20 $140.00
Issued Date:4/22/2021 1 of 2
t4, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
u 2 CITY OF ATLANTIC BEACH
PLRS21-0069
800 SEMINOLE ROAD ISSUED: 4/22/2021
ATLANTIC BEACH. FL 32233
EXPIRES: 10/19/2021
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.93
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$199.93
Issued Date:4/22/2021 2 of 2
Plumbing Permit Application **ALL INFORMATION
�� HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 M
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: vak--- Do t8
JOB ADDRESS: f 0-7 (SG\ cjv'Q- PROJECT VALUE $ g/ 0 co • �'�
❑NEW OR REPLACEMENT INSTALLATION and/or ERE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory �� Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS
❑ Sewer Replacement
Li Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler heads)
❑ Grease Interceptor(Trap) gallons (Requires 3 sets of plans)
Cl Well **5lRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
n 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: Phone Number:
Plumbing Company:-(J c. Office Phone:'3 09-.S 7.i9) Fax s1.9 tS13
Co. Address: LitAl t. LoN-1S 0 Q- City:'+41 _ State: FL Zip:
License Holder:T2PO Co A`�� St e Certification/Registration #C hC-J'"t2=70(:)-
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this L 2- day of Ayr i I , 20 21, in the State of Florida,
County of OtA V011
Signature of Notary Public GA c pyitt.
«*�t' CHRISTIAN GILES
• e. MY COMMISSION k HH 117153
'•'.���:* EXPIRK:Apri113,2025 [ ] Personally Known OR [4Produced Identification
?if-i$'• Bonded Thai Notary Public Underwriters Type of Identification: F) - Yi v v' Li C.Qr'S'e'
Updated 10/17/18