1811 Selva Marina Dr. PLRS22-0147 Permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLR522-0147
n SOO SEMINOLE ROAD ISSUED: 10/3/2022
+L o EXPIRES:9/1/2023
ATLANTIC BEACH. FL 32233
• • • • • • • •• t • • • •
CODE, NEC, I AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
FNOTIC.E: addition to the requirements of this permit,there may be additional restrictions applicable to this property
e found in the public records of this county,and there may be additional permits required from other
ntal entities such as water management districts,state agencies,or federal agencies.
. ADDRESS:
1811 SELVA MARINA DR PLUMBING RESIDENTIAL SHOWER PAN $1500.00
SUBDIVISION:TYPE OF REALESTATE BUILDING USE
CONSTRUCTION: NUMBER: ZONING: GROUP:
172020 0764 SELVA MARINA UNIT 1013
ADDRESS: CITY: STATE: ZIP:
KIDS VENTURES LLC 27184 Murrhee Rd. Hilliard FL 32046
• ADDRESS:
PHILIP BLUMENTHAL 1811 SELVA MARINA DR ATLANTIC BEACH FL 32233
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 4550000422-1000 0 $55.00
PLUMBING FIXTURES 455-0000.322-1000 1 $700
STATE DBPR SURCHARGE 455-00002080700 0 SEW
STATE DCA SURCHARGE 455-0000-2080600 0 $2'00
TOTAL:$66.00
Issued Date:10/3/2022 1 of 2
>> PlumbingPermitA lication "ALL INFORMATION
pp HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY 15REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 el,RS Z Z -0(47
Phone: (904) 247-5826 Email: Building-DeptOcoab.us PERMIT#: RC_32Z— d>23
JOB ADDRESS: /��// 5G1✓R It ftiA PROJECTVALUE$ ffOef
LI NEW 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
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
LaundryTray Water Connected Appliances_
Lavatory Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS
O Sewer Replacement
❑ Back Flow Preventer
❑ Lawn Sprinkler System (number of sprinkler heads)
O 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 or local law regulation construction or the performance of construction.
Owner Name:C 11- fGx Vdry .n galerler IN,4 j ,we wol*bne Number: 78'6-,a3 ?- 3&,Dc—
Plumbing Company: 1e4 C' I✓Lh7rilr/ Office Phone: &,;!&-3*Yc2 R Fax
Co.Address—'22/.F/ �GF��s t /1-.g City:^���1�"�7 State FC. Zip: 'R 20 `f�
License Holder: o� State C ' ' ation/Registration nCr`C/S/..27�/0�
Notarized Signature of License Holder
The foregoi t trument as acknowledged before day 21y the State of Florida,
County of
; ;y, TONT GINDLESPERGER
R' NIY COMMISSIONNGG 333178 Signature of Notary Public � 5
E%P
IRES'.O�toba�8,2023 6
�`7�eandadib�u Noury PublkUMenrtxars
rsonally Known OR[ ] Produced Identification
Type of Identification:
Updatedle/17/18