1093 Hibiscus St PLRS21-0105 11 Fixtures �, o,- ic.6) PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
J PLRS21-0105
1 . CITY OF ATLANTIC BEACH
-v•iiii
800 SEMINOLE ROAD ISSUED: 7/8/2021
ass • v EXPIRES: 1/4/2022
ATLANTIC BEACH, FL 32233 i
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:
1093 HIBISCUS ST PLUMBING RESIDENTIAL Plumb: 11 Fixtures $4500.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171088 0114 BEACH HARBOR
COMPANY: ADDRESS: CITY: , STATE: ZIP:
STEEG PLUMBING 1601 MAIN STREET ATLANTIC BEACH FL 32233
COMPANY INC
OWNER: ADDRESS: CITY: I STATE: < ZIP:
TURNBULL NORMAN L 12076 HANSON CREEK DR JACKSONVILLE FL 32258-5386
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT II\
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 0 $0.00
PLUMBING FIXTURES 455-0000-322-1000 11 $77.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2 00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2 00
TOTAL:$136.00
Issued Date:7/8/2021 1 of 2
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
f---_ CITY OF ATLANTIC BEACH PLRS21-0105
T 800 SEMINOLE ROAD ISSUED: 7/8/2021
ATLANTIC BEACH, FL 32233 EXPIRES: 1/4/2022
Issued Date:7/8/2021 2 of 2
**ALL INFORMATION
s'';;%,- Plumbing Permit Application AIGHLIGHTEAIN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone:Iril
(904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: /v /5 Hf /,ey5 PROJECT VALUE$ '0- 2V,a)
❑NEW OR REPLACEMENT INSTALLATION and/or RE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub
I , Septic Tank& Pit
Clothes WasherShower 1
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet Z
Hose Bibs )-• Urinal
Kitchen Sink / Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory —2___ Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS
❑ Sewer Replacement
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler heads)
❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Well **SJR D Well Completion Form.Completed form to be submitted to the Building Department for final inspection.**
❑ Other 4/A h ,) C�
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: �/f/-/ "WGr 1C�f/1l. Phone Number: e&7-",‘91:614:7
Plumbing Company: PCG �l 49 /h✓ Office Phone:!�' 7 c.v l Fax
Co. Address: lei/ /Olmlm 51 City: ht 667( State:0"/ Zip: ,?,%3
License Holder: U/� It State Certification/Registration#Z�JliG//��AO
Notarized Signature of License Holder AY
The foregoing instrument was acknow,-AO
.ged before me this d day of J U Li , 202_1, in the State of Florida,
County of 0v V f+L
Signature of Notary Public % /IJLL,
r
i.,:► CHRISTIAN GILES
ti4 MY COMMISSION#HH 117153 [ ] Personally Known OR [ croduced Identification
•.�-
�; EXPIRSS:April13,2025 Type of Identification: / -- P
'.;;os i o EonoedTTN NotaryPublic U derwdt6►$
Updated 10/17/18