1732 Sea Oats Dr PLRS22-0175 Permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLR522-0175
800 SEMINOLE ROAD
ISSUED: 11/30/2022
r,v.. ATLANTIC BEACH, FL 32233 EXPIRES: 5/29/2023
CODE,MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
AND CITY OF • • OF ORDINANCES .
ALL CONDITIONS OF
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.
• • ADDRESS: PERMIT TYPE: DESCRIPTION:
1732 SEA OATS DR PLUMBING RESIDENTIAL PLUMBING - 17 FIXTURES $16000.00
ZONING:TYPE OF REALESTATE SUBDIVISION:BUILDING USE
CONSTRUCTION:— NUMBER: GROUP:
172020 0434 SELVA MARINA UNIT 08
COMPANY: ADDRESS:
KOS VENTURES LLC 27184 Murrhee Rd. Hilliard FL 32046
• ADDRESS:
DEBELEN CHRISTOPHER 1732 SEA OATS DR ATLANTIC BEACH FL 32233
USON
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT P
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 455-0000-3221000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 17 $11900
STATE DERR SURCHARGE 455-0000-208-0700 0 $2.61
STATE DCA SURCHARGE 455-0000-2080600 0 52.00
TOTAL:$178.61
Issued Date:11/30/2022 1 of 2
Alift Plumbing Permit Application **ALL INFORMATION
p HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233IV _
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT r1:rQGdV Z2-❑DOL
JOB ADDRESS: 12-2-.1 !�� Owls- z2e PROJECT VALUES' I40.
❑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 Tr
Hose Bibs Z Urinal
Kitchen Sink Vacuum Breakers
LaundryTray Water Connected Appliances
Lavatory 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 ** VRWD 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: 0�z F/s 7.PW ems- I)S,6 Phone Number:
KPS ///J f (/����
Plumbing Company: �z/ Office Phone: fP36 -3S/a- 3 Fax
Co.Address�27/9:k ow&zelok �/J City: State: Zip:
License Holder: /State Certification/Registration NCf'C AV,2 236F
Notarized Signature of License Holder �.*
The foregoingivisftument w s acknowledged before me this�y 20Z 5,,the State of Florida,
County of 0\/�
Taus GIHDLESPERG .Signature of Notary Public L
qrl YC GMMIBGIGN q GG 3597)a
i'ss *e:` EXPIRES:ou,brrs,zon [ ] Personally Known OR [ ] Produced Identification
Bei°eOTMx^'vrnruMcwwMmm Type of Identification: Q) • L
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