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1282 Hibiscus St 2012 sewer connect SI, CITY OF ATLANTIC BEACH l 800 SEMINOLE ROAD r� ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00001662 Date 11/15/12 Property Address . . . . . . 1282 HIBISCUS ST Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 --------------------------------------- Application desc NEW SEWER ---------------------------------------- Owner Contractor ----------- ------------------------ PATTEN, JAMES CHRISTY FIRST COAST PLUMBING 1282 HIBISCUS STREET 1651 MAYPORT RD ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 247-4419 ------------------------------------- Permit PLUMBING PERMIT Additional desc SEWER REPLACEMENT 00 Permit Fee . . . . 62 . 00 Plan Check Fee Issue Date . . . . Valuation . . • • 0 Expiration Date . . 5/14/13 _ ------------------------------- Other Fees . STATE PLBG DCA SURCHARGE 2 . 0 STATE PLBG DBPR SURCHARGE 2 . 00 _____ _ ________ -- Fee summary Charged Paid Credited ----Due--- ---------- Permit Fee Total 62 . 00 62 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 66 . 00 66 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Nov 08 12 09:46a Christy First Coast Plumb 9042494660 P.1 PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach,FL 32233 I� Ph, (904) 247-5926 Fax(904)247-5845 4071_1&6 �2 JOB ADDRESS: ZA aI l[J� 7 � �7 � 1 PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value S TYPE OFFMTURE 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 Laundry Tray Water Connected Appliances Lavatory Water Heater n Other Fixtures Water Treating System / I/ J RE-PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub -Septic Tank&Pit Clothes Washer Shower k Dishwasher Shower Pan D gmountatn SlopSink Floor Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MOCELLANEOUS: ewer Replacement o Back Flow Preventer O Grease Interceptor(Trap) gallons(Requires 3 sets of laps) © Lawn Sprinkler System-Number of Heads a Well ** �i a V,I Cr **SIRWD Well Completion Form. Completed form to be submitted to the Building Department for Phial inspection.** cYn I] Other Permit becomes void if work does not commence within a sixmonth 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 goveming this work will be compiled with whether specified or not- The permit does not give authority to violate the rovisions of any other state or.local Iaw regulation construction or the performance of construction. (lam Phone Numbers l Property Owners Name '�' �" , Plumbing Company 1651 Ma Ofd Road Office Phone Fax �' Co.Address: ll� Atlantic Beach, FL 32233 city State zip License Holder(Print): S le C on/Registration# Notarized Signature of License oder MUEYOUNGCHRISTY Sworn and subscri4ed l re m s/ day of 20� :.: . �4Y COWlS'M A DD 873293 EXPIRES:duty 21,2013 Signature of Notary Public Bonded Thru t"Public Underwriters I CITY OF ATLANTIC BEACH, FLORIDA VOLUNTARY ASSESSMENT AGREEMENT PROPERTY DESCRIPTION: OWNER: James R. Patten,Jr. 1282 Hibiscus St. Atlantic Beach,Florida 32233 PROPERTY ADDRESS: 1282 Hibiscus St, RE#: 171058-0000 LEGAL DESCRIPTION: 17-2S-29E Sec H Atlantic Beach Lots 1,2 BLK 231 This document shall serve as an extended payment agreement between you and the City of Atlantic Beach,Florida for the above listed total amount and for which said amount will be filed as a lien with the Court of the Circuit Court for Duval County,Florida until the entire balance is paid. CHARGES: System Development Charge$4,050.00 Contractor 2,942.50 Filing Fees 35.50 TOTAL CHARGES FINANCED: $7,028.00 TOTAL INTEREST OVER LOAN TERM: $1.510.61 TOTAL AMOUNT OF AGREEMENT/LIEN: $8,538.61. TERMS: Number of Monthly Payments 120 Due Date Due monthly with your utility bill Billing Included on utility bill Late Charges 10% Failure to pay all charges will result in the water services being cut-off. Payment Amount $71.16 per month Total Interest over term of loan $1,510.61 Interest Rate 4.00% LIEN:A lien in the amount of the TOTAL AGREEMENT above shall be executed and recorded against the above referenced properties. The owner hereby agrees to pay all recording fees and costs involved with the execution of the lien. Upon payment being made in full,the lien shall be released of record. Please indicate your acceptance of the provisions of this agreement by signing in the place indicated. Your signature signifies your agreement to indemnify and hold harmless the City of Atlantic Beach,FL,from any and all damages resulting from your failure to timely make the above payments, including reasonable attorney'.-;fees and court costs. Property Owner By Date: es R. Patten, Jr. Citv of Atlantic Beach y: Date: "o B __ -- Jim HA uson,City Manager ♦ 'r�S�-L`l r��� CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J - ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00000791 Date 11/15/12 Property Address . . . . . . 1282 HIBISCUS ST Application type description SYSTEM DEVELOPMENT CHARGE RESIDENTIAL (S Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Septic to sewer conversion ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ PATTEN, JAMES OWNER 1282 HIBISCUS STREET ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . ADV PMT-SEWER IMPACT FEE Additional desc . . SEPTIC TO SEWER SDC CHGS Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . . 11/15/12 Valuation . . . . 0 Expiration Date . . 11/15/12 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . SEWER SDC-SYSTEM DEV CHG 4050 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total . 00 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4050 . 00 4050 . 00 . 00 . 00 Grand Total 4050 . 00 4050 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. REORDER 905•U.S.PATENT NO.5538290,5575508,5641183,5785353,5984364,6030000 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH.FLORIDA 32233-4445 CITY OF ATLANTIC BEACH } / 800 SEMINOLE ROAD ATLANTIC BEACH FL 32233 CITY OF ATLANTIC BEACH NO. 107770 800 SEMINOLE ROAD ATLANTIC BEACH.FLORIDA 32233-4445 INVOICE INVOICE PURCHASE PROJECT ACCOUNT AMOUNT NUMBER DTE ORDERN[). NUMBF,R NUMBER RE# 171058-0000 11/13/2012 410-5506-535.34-07 4,050.00 (.ROSS RETAINAGE DISCOUNT NE' $******4,050.00 $******4, 050 . 00