270 5th ST PLRS21-0087 , ,,:s1.--JJ PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
`� CITY OF ATLANTIC BEACH PLRS21-0087
ISSUED: 5/26/2021
�r
800 SEMINOLE ROAD
-`Ov ATLANTIC BEACH, FL 32233 EXPIRES: 11/22/2021
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:
270 5TH ST PLUMBING RESIDENTIAL REPIPE - 3 FIXTURES $2000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172557 0000 ATLANTIC BEACH
TERRACE
COMPANY: ADDRESS: CITY: STATE: ZIP:
STEEG PLUMBING 1601 MAIN STREET ATLANTIC BEACH FL 32233
COMPANY INC
-b1NNER: ADDRESS: , CITY: STATE: ZIP:
FLYNN GAY E 270 5TH ST ATLANTIC BEACH FL 32233-5312
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55 00
PLUMBING FIXTURES 455-0000-322-1000 3 $21.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$80.00
Issued Date:5/26/2021 1 of 2
Plumbing Permit Application **ALL INFORMATION
HIGHLIGHTED IN
; Ci
ltyy of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
""` Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:PL.r2SZ 1 0087
JOB ADDRESS: 27c PROJECT VALUE$ 20) m
❑NEW OR REPLACEMENT INSTALLATION and/or,RE-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 I
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory / Water Heater
Other Fixtures Water Treating System
DI MISCELLANEOUS
❑ Sewer Replacement
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler heads)
O 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.**
O 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: (.4 (15 C1 /i'4- Office Phone: 2.44?--5-19( Fax
3 �
Co. Address: ,16&/ �/I) 9/---- City: 116 721\ State Zip: 5Zz33
License Holder: .„..;------ii-)A, �e-IA State Certification/Registration # �,-L:437//b
Notarized Signature of License Holder ' , of ice fee.,
The forego vEN stru nn entfrias acknowledge. before me this i •ay of(\AU L , 20Zlin the State of Florida,
County of LJUNIQA
r
tit
.44,":/".t"4%,,:, TONIGINDLESPERGER Signature of Notary Publi law'a �_' -
.4.••••4,. ..-.. MY coMMISSION#GG 353178
* " V V EXPIRES:October 6,2023 personally Known OR [ ] Produced Identific. ii#
,ib'•gP•° Bonded live Notary
Public Undervrtiters
Type of Identification:
Updated 10/17/18