57 Donner Rd plbg permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, Fl,32233
—4,J,19 INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0078
Description: 14 FIXTURES
Estimated Value: 0
Issue Date: 8/16/2017
Expiration Date: 2/12/2018
PROPERTY ADDRESS:
Address: 57 DONNER RD
RE Number. 1720640010
PROPERTYOWNER:
Name: 51DONNERCDLLLC
Address: 355 11TH ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: CANNON PLUMBING, INC.
Address: 1794-1002 ROGERO RD CA OUN MARSHALL CANNON
JACKSONVILLE, FL 32211
Phone:
PERMIT INFORMATION:
Please see aftached 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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5945 PLRS D-oo-e
JOB ADDRESS: 7 DONNrR ROAD PXRMT#
NEW OR REPLACEMENT INSTALLATION: Project Value$-3000.00
TYPEorFbaulau TYPEoFFLAiTURE QTF
Bathtub Septic Tank&Pit
Clothes Washer Sbovmr
Dishwasher Shower Park I
Drinking Fountain Slop Sink
Flom Drain Three Compartment Sink —
Fluor Sink Toilet 3—
HoseDibs Urinal
Kitchen Si k Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater I
Other Fixtures Water Treating System
RE-PIPE:
Tyrr of,FmwRE QTY TYPEOFFiXTURE OTY
Bathtub Sepotie;Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Ibm Compartment Sink
Fluor Sink Toilet
How Bibs Urinal
Kitchen Sink Vacuum Breakers;
Laundry Tray Water Connected Appliances
I.Avallory Water Heater
Other Fixtures Water Training System
MISCELLANEOUS:
0 Sewer Replacement El Back Flow Preventer C3 Grease Interceptor(Trap)_gallons(Requires 3 set*of plans)
13 Lawn Sprinkler Systenn-Number of Heads 0 wen
**sjRwD well completion Form.completaTfor—mto be submitted to Ge-B—uilding Department for final inspection."
o Other
Nmit bactews vuld If work does not tionancrica within a six month Wind or work Is suspended or abandoned for six months,I hersby certify this I have read
this applIcation east Imow the assic in be trw ani coarect. All provisions of laws and ordinances governing this�ork will be complied with whoilhor 3pocifled
ornot. Tim pennitdoes not low withority to violate the provisions of my otherstate or local law regulation conetiviction orthc parforensoca otcoostruction.
Property Owners Name 51 DoxmierQDL LLC PhoneNuraber 904-686-1818
PlumbingComplarly ClamatmPlumbiristlac 904-744-6350 ax 904-551-041AS
Co.Address: 1718 E Church Street City Jacksonville State FL Zip 32202
License Holder(Print): Olin Cannon-State Certification/Registration# CFC1426140
Notarked Signmum-of License Holder
I 4�2% LESLIEDALe Sworn an subscribed before me this 15 dayof August 20 7
A ConinilsolonlYFF144322
IW3 Exoresddy23,21118
Signature of Notary Public 0414,-
1
Cash Register Receipt Receipt Number
[a City of Atlantic Beach R2314
DESCRIPTION ACCOU
PermitTRAK $569.90
PLRS17-0077 Address:47 DONNER APN: 172064 0000 $157.30
PLUMBING $153.00
PLUMBING BASE FEE -0 E $55.00
PLUMBING FI)CTURES 415-OZE2_11200LI) $98.1))
STATE SUR0,IARGES $4.30
STATE DBPR SURCHARGE 455 0000�108
$_�.30
STATE DCA SURCHARGE 455000020& $"o
PLRS17-0078 Address: 57 DONNER RD APN: 172064 0010 $157.30
PLUMBING $153.00
PLUMBING BASE FEE 455 OWO-322 10W 0 $55.00
PLUMBING FIXTURES 455 0000-322-1000 14 1 $98.00
STATE SURCHARGES $4.30
STATE DBRSURCHARGE S-0000-208-0600
STATE DCA SURCHARGE 0 1 !1�020
L'15500002080700 0
PLRS17-0080 Address:55 DONNER RD APN: 172064 0010 $157.30
PLUMBING $153.01)
PLUMBING BASE FEE 512000-E 00 0 1 $55 00
1 L
451W�12EZ T1
PLUMBING FIXTURES
STATE SURCHARGES $4.30
STATE DBPR SURCHARGE 3-0600 0 1 $2 30
STATE DCA SURCHARGE 0 1 $2.00
PLRS17-0081 Address:49 DONNER RD APN: 172064 0000 $98.00
PLUMBING $98m
PLUMBING FIXTURES 455 GOOO-322 10nn 14 $98.00
TOTAL FEES PAID BY RECEIPT: R2314 $569.90
Date Paid:Wednesday,August 16, 2017
Paid By: LYLES TOMMY
Cashier: BA
Pay Method: CREDIT CARD 3
Printed:Wednesday,AugUst 16,2017 2:01 PM 1 of 1
CITI OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
06,16 2017 11W54
CREDIT CARD
VISA SALE
Cad# XmwWV=6fi
SEQ 3
W#: 427
INVOICE 3
Appmvil Coot 0218BI
Envy Method. manull
Mode: Cnive
Tax knout: $0.00
C
6
S 3
427
3
18BI
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xd�j
$0 00
Card Godc M
SALE AMOUNT p9l
CUSTOMER CON