44 Dewees Ave #U PLRS21-0123 15 Plumb Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
k\ PLRS21-0123
CITY OF ATLANTIC BEACH
''
800 SEMINOLE ROAD ISSUED: 8/16/2021
EXPIRES: 2/12/2022
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'; 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.
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.
' 6IADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
44 DEWEES AVE #U PLUMBING RESIDENTIAL 15 Plumb Fixtures: INTERIOR $4500.00
REMODEL AND ADDITION
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169550 0000 OCEAN GROVE UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
1 WHITEHEAD PLUMBING 125 DIEGO ISLAND CT ST. AUGUSTINE FL 32095
INC
OWNER: i ADDRESS: CITY: STATE: ZIP:
SLATER THOMAS F 44 DEWEES AVE ATLANTIC BEACH FL 32233
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.
=,. �., ..... ,.• UST 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 15 $105.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.40
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date:8/16/2021 1 of 2
Me A V* $R94. 4D
Plumbing Permit Application **ALL INFORMATION
%fJ "'. HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
4 800 Seminole Rd, Atlantic Beach, FL 32233 I1�
'-');_c-iii . Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: ToP
JOB ADDRESS: Aik , PROJECT VALUE $ 1910
/NEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE 1/�j
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 1 Septic Tank & Pit
Clothes Washer4-- Shower
Dishwasher Shower Pan I
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet _
Hose Bibs Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray 1 Water Connected Appliances
Lavatory 4 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 **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 r local law regulation construction or the performance of construction.
Owner Name: IAll Phone Number:
C16±Wgett
Plumbing Compan : IL A ii-.4.• Office Phone:01111tolfritie Fax
Co. Address: \7/5 D Wit9 C00 City: jç\M. State:,. Zip: -' 7,41,r)
License Holder: 14-0' '.3-)(\
State Certification/Registration #
Notarized Signature of License Holder 1\ 414400
The foregoing instrument was acknowledged before me this 1(0 day of AUGUST , 2021, in the State of Florida,
County of DU V41,
Signature of Notary Public Gi
k-//q(all--A"
:, ,,- CHRISTIAN GILES [ ] Personally Known OR [ Produced Identification
• I MY COMMISSION#HH 117153
"' Type of Identification: /
_; .��oP;� EXPIR6S:Apri11s,2025 Yp �L- ��
°r,",•• Bonded Thru Notary Public Underwriters Updated 10/17/18