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1871 Selva Marina Dr plbg permit CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 PLUMBING RESIDENTIAL - MUST CALL BY 4PM FOR NEXT D"INSPECTION: 247-S814 PERMIT INFORMATION: PERMIT NO: PLRS17-0070 Description: 5 FIXTURES Estimated Value: 0 Issue Date: 8/8/2017 Expiration Date: 2/4/2018 PROPERTY ADDRESS: Address: 1871 SELVA MARINA DR RE Number: 1720200946 PROPERTYOWNER: Name: POWELL GREGORY M Address: 1871 SELVA MARINA DR ATLANTIC BEACH, FL 32233-6619 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: THE MALLE COMPANY, INC Address: 12627 SAN JOSE BLVD APT 106 QA FRANK MALUE JACKSONVILLE, FL 32223 Phone: PERMIT INFORMATION: Please see attached conditions of approval. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU 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. *A notice of Commencement is only required for work exceeding an estimated value of $2,500.For HVAC work, a Notice of Commencement is only required when HVAC work exceeds and estimated value of$7,500. _��iermit pplication City of Atlantic Beach 800 Seminole Road,Atlantic Beach,Fl.32233 Job Address: Phone: (904)247-5826 Fax:(904)247-5845 PLRS17-007b _M11 Sfln ijun ,)A l)c. Permit Number Legal Description 3 '1 iooe-i8-Z9c —RE# Valuation of Work(Replacement Cost�$ 10190 M..td/Cool.d SIF 3 0 Nor.H.sftd/CooI.d_2C2j_ • Class,of Work(Circle one): New Addition Alteration/Repo,i9Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial • If an existing structure,Is a fire sprinkler system Installed?(Cirde one): Yes No (Nbo • Submit a Tree Removal Permit Application if any trees am to be removed or Affidavit of No Tree Removal Describein detail the type of work to beperformed: 3 sv)ov�-r VA%'re6' /V) Florida Product Approval# for multiple products use product appr—ovai form eropeJE4 Owner Information Name: .'r' weill Address: I R -11 Se IV& Ur - City '('+t,t lr� 5tateEL—Zip -327 33 Phone E-Mail Owner or Agent(if Agent,Power of Attorney or Agency Letter Required) Contractor Infamnatio Name of Compan I Quali ing'Znt: C4 IV MRik, Address-54�Z� (74 ro I State k zip.'32 e)177 Office Phone 9 Qn- S,y S 7, ad Number 0 State Certiffication/Registration a C rC I Li 7 Q7.' E-Mail Sk 6fA Architect Name&Phone N Engineers Name&Phone Workers Compensation-Tn T41 t Exmpt/inww/UweEmp�s/�pimWn� Application is hereby made to obtain a permit to do the work and Installations as indicated,I certify that no work or Installation has commenced prior to the Issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLU MSMG;SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,atc. OWNER'S AFFIDAVIT:I certify that all the foregoing Information Is accurate and that all work will be done in compliance with ail applicable laws regulating construction and zoning. WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. (��ature of Owner or Agent including Contracton (Signature of contractor) Signed and sworn to(or affirmed)before me this_day of Stared anda swom to(or affirmed)before me this—1 day of by &&LL_aL0_'by 1�""A 4441 �7 il (Signature of Notary) 01, Feb,uo,y 16, 20 Personally Known OR VY15srsoral?y Known OR .1 I Produced Identification [ I Produced laertnication Type of Identification: Type of Iderfification: Cash Register Receipt Receipt Number City of Atlantic Beach R2226 ACCOUNT CITY PAID $94.00 PermitTRAK PLR517-0070 Address: 1871 SELVA MARINA DR APN: 172020 0846 $94.00 $9000 PLUMBING 455-0000-322A000 0 $55.00 PLUMBING MSE FEE - ------- ---- $35.00 $4.00 PLUMBING Ci�l IRFq ni;if fl STATE SURCHARGS $2.00 STATE DBPR SU RCHARGE 455-0000-208-0600 0 _I 00 DCASURCHARGE 75TATE771 45500002138VIM 1 Date Paid:Tuesday,August 08,2017 Paid By: POWELL GREGORY M Cashier: BA Pay Method:CREDIT CARD 8 P(inted:Tuesday,August 09,2017 11:02 AM 1 of 1 MYOFATWMCBEACH 800 SE14NOLE RD ATLANTIC BBC,FL 32233 WNW 11:01:26 CREDIT CARD VISA SALE 4 Card 4 20000=6914 4 S SEQ#: 8 EQ 0 421 IWOICE 6 INV Icl Approval Col: 0311307 ppr"a E*y K4w: mnwi W y " Mode. 0*9 e TTax Arad: $0DO ax CCard CA: M ar C' WE�MOUNT CUSTOMER COPY