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647 Selva Lakes PLRS22-0052 Plumbing Permit N`' '`• PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH PLRS22-0052 • 800 SEMINOLE ROAD ISSUED: 4/5/2022 ATLANTIC BEACH. FL 32233 EXPIRES: 10/2/2022 INSPECTIONMUST CALL • 14FOR DAY INSPECTION. ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITIONr OF • • • • BUILDING CODE, AND CITY OF • • OF ORDINANCES . ALL CONDITIONS or 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. • • err • r • OF • • 647 SELVA LAKES CIR PLUMBING RESIDENTIAL PLUMBING - 15 FIXTURES $1500.00 ZONING:TYPE OF REALESTATE SUBDIVISION:BUILDING USE CONSTRUCTION: NUMBER: GROUP: 172027 5900 SELVA LAKES UNIT 03 COMPANY: rr • STYLES SMITH PLUMBING, JACKSONVILLE INC 1537 PENMAN RD SUITE A BEACH FL 32250 • ADDRESS: CITY: STATE: ZIP: TORRES JONATHAN 647 SELVA LAKES CIR 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. 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 455-0000-322-10M 0 $55.00 PLUMBING FIXTURES 4SS-MW-3221000 15 $105.00 STATE DBPR SURCHARGE 455-MM-208-07M 0 $2.40 STATE DCA SURCHARGE 455-0000-2080600 0 $200 TOTAL:$164.40 Issued Date:4/5/2022 1 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 Phone: (9044)'247-5826 Email: Building-Dept@cclab.us PER IT#: JOB ADDRESS: 4- 4/7 5e,VA L 4xe s5//Gir PROJECT VALUE ❑NEW OR REPLACEMENT INSTALLATION and/or & E-PIPE TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub .1 Septic Tank& Pit Clothes Washer Shower 1 Dishwasher 1 Shower Pan 2 Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs :t Urinal Kitchen Sink 1 Vacuum Breakers Laundry Tray Water Connected Appliances_ Lavatory Water Heater 1 Other Fixtures Water Treating System ❑MISCELLANEOUS 1 ❑Sewer Replacement /\ ❑ Back Flow Preventer ❑ Lawn Sprinkler System (number of sprinkler heads) Grease Interceptor(Trap) gallons(Requires 3 sets of plans) r' Well "SIR,��vt�D Wel/Comp/eyon Form.Completed form to be submitted to the Building Department for final Inspection.•' Other ?teDZC / M J�of n l<tic fib✓ fo G' Y i 6 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: � nn 4-1 Vt cin I O f'1`e S Phone Number: p/� . Plumbing Company: ��p 5 CIMi fit !l.N/�/� fficGe Phone: goy :Z 2//'y/�/ Fax Co.Address: 1537 Ppil,.•rnr Id City: TNc BeA&a State:tCL. Zip: 3,2A.50 License Holder:l7ITr�Pi[l- 4",z/7 State Certification/Registration# /-A6 IYA W0g� Notarized Signature of license Holder G The foregoi rument was cknowledged before me thisada 2C;—?",the State of Florida, County of O ai Signature of Notary Public MM jPersonally Known OR [ ] Produced Identification DLESPERGER Type Of Identification: SIDNg GG 3u,377gDctabere,2023upaahaao/i7rya ry PUNk lhge�wrlbrs