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1580 SELVA MARINA DR PLRS21-0153 - ;:S'''' '',,, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER r`��'"_ 1 CITY OF ATLANTIC BEACH PLRS21-0153 �� v 800 SEMINOLE ROAD ISSUED: 10/13/2021 `'':"� ATLANTIC BEACH, FL 32233 EXPIRES: 4/11/2022 , 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 1580 SELVA MARINA DR PLUMBING RESIDENTIAL SEWER REPLACEMENT $1800.00 TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 171989 0000 SELVA MARINA UNIT 04 COMPANY: ADDRESS: CITY: STATE: ZIP: ADVANTAGE PLUMBING 880 MAYPORT RD JACKSONVILLE FL 32240 BEACH ADDRESS: CITY: I STATE: ZIP: KRING MICHAEL D 1580 SELVA MARINA DR ATLANTIC BEACH FL 32233-5614 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. WIF 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 1 $7.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$66.00 Issued Date: 10/13/2021 1 of 2 0 d.,.,r Plumbing Permit Application "ALL INFORMATION HIGHLIGHTED IN .• - City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 P LRS z - O i S3 -'` Phone: (904) 247-5826 Email: Building-Dept@coaib.us PERMIT#: JOB ADDRESS: l Qv CA \i'\,A c‘-V—,,,,r t 1,2 PROJECT VALUES `'- [EW OR REPLACEMENT INSTALLATION and/or ORE-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 -lour Sink Toilet Hose Bibs Urinal Kitchen Sink _ Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System DoISCELLANEOUS • Sewer Replacement DBack Flow Preventer °Lawn Sprinkler System (number of sprinkler heads) Grease Interceptor (Trap) gallons (Requires 3 sets of plans) ❑Well "SARNp we:c anpleiipR Form.Completed form to be submitted to the Building DeparCmtrt'tor fire Ism+[-,;on. •• QOttter Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. 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 wili be complied with whether specified or not. The permit does not give authonty to violate the provisions of any other state or local law regulation construction or the performance of construction. Qwner Name: L��(e C`� CL S Q / Gtr l iA '' Phone Number Ci0<{ cj1-{j I l.Q D ` l[lI J Plumbing Company: 1'A �(t.v\k/1� C. \l A4vno 111 Office Phone:�O4- 1 1 CCN Fax Q�2 \M � J p � Co. Address: t'Sb V V a ��v� V___A Ci;Y �+\Cl lc"iCIC l State:Il Zi �� p: ,ZZ �: License Holder: 6:At- (-1 � 7(--, �!,q us 67- State C ' nation/Registration # cFc f yes �,5--.7 Notarized Signature of License Holder . The foregoin instrument was acknowledged before me this 13 day of��t, 202-1, in the State of Florida, County of . l iI 04- Signature of Notary Public_ II ) CHRISTINA FRISBEE CLARK * _,- * Commission a HH 143799 )( ersonaUy Known OR j j Produced Identification ,N 14 7 Expires July 12,2025 ' 09. Type of identification: or•a 9aided Dim Budget nowt'Unto `-?aaw ✓:;•/1