761 Cavalla Rd PLRS22-0058 Plumbing Permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
n CITY OF ATLANTIC BEACH PLR522-0058
800 SEMINOLE ROAD ISSUED:4/13/2022
'I v� ATLANTIC BEACH, FL 32233 EXPIRES: 10/10/2022
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • • • • '
CODE, AND CITY OF • • 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.
• • • r . • r • OF • •
761 CAVALLA RD PLUMBING RESIDENTIAL PLUMBING - REPIPE $2500.00
ZONING:TYPE OF REALESTATE SUBDIVISION:BUILDING USE
CONSTRUCTION: NUMBER: GROUP:
171347 0000 ROYAL PALMS UNIT 02A
COMPANY: ADDRESS:
• ADDRESS:
EDWARDS TERESA ELAINE 761 CAVALLA RD ATLANTIC BEACH FL 32233-3916
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 455-00003223000 0 $55.00
PLUMBING FIXTURES 4550000-322-1000 1 $700
STATE OBER SURCHARGE 455.0000.208.0700 0 52.00
STATE DCA SURCHARGE 455-CM'0-20806M 0 $200
TOTAL:$66.00
Issued Date:4/13/2022 1 of 1
Plumbing Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 U LRS 2Z_c)O SIS
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMITT#:
JOB ADDRESS: 7(o ( CA, f0.LC0. RtaO PROJECT VALUE$ G �
❑NEW OR REPLACEMENT INSTALLATION and/or]41RE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank& Pit
Clothes Washer I Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Z Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray Water Connected Appliances_
Lavatory I Water Heater
Other Fixtures 2. Water Treating System
❑MISCELLANEOUS
❑ Sewer Replacement _
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler heads)
r, Grease Interceptor(Trap) gallons(Requires 3 sets of plans) L IZSZz-003 �,
❑ Well •'SJRWD Well Completion Form.Completed form to submitted the�`'ilding Department for final inspection."•
❑ Other r L' (� l p - i��� c� ritt=S o n S Hie 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: .\per `cam,tL,C! Phone Number: 56 N '704 LIL S/o
Plumbing Company: I-\a(o*n/\ Office Phone: Fax
Co.Address: Ikla'1 CGl(,,jCn ` ia,\ City: sat ' State: YLzip: 32z/6
License Holder: State Certification/Registration#
Notarized Signature of License Holder ZC U C.-)C\ 0- F-
Theforegoi ument wa acknowledged before me this , 2t� ' the State of Florida,
County of L
Signature of Notary Public f
[ ] Personally Known OR [ ] Produced Identification
TONI GINDLESPERGER Type of Identification:
MY COMMISSION#GG 363176
..p-` EXPIRES:October 6,2023 u0earee top J/18
;B0_^-tlM fivNotery Publk llntlervMen