55 Donner Rd 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 NE)Cr DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0080
Description: 14 FIXTURES
Estimated Value: 0
Issue Date: 8/16/2011
Expiration Date: 2/12/2018
PROPERTY ADDRESS:
Address: 55 DONNER RD
RE Number: 1720640010
PROPERTY OWNER:
Name: 51 DONNERCDLU-C
Address: 355 1 1TH ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFOR14ATION:
Name:
Address:
Phone:
Name:
Address�
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 ITVAC work
exceeds and estimated value of$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, Fl,32233
Ph(904)247-5826 Fox(904)247-5845
JOB ADDRESS: 65 DONNER ROAD —PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ 3000,00
TyrvoFFLVmRE QTY TYPE oir PxnrRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan I
Drinking Fountain Slop Sink —
Floor Drain Three Compartment Sink
Floor Sink Toilet 3—
Hose Ribs Urinal
Kitchen Sink I— Vacuum Breakers
Landry Tray — Water Connected Appliances
Lavatory 4— Water Heater I
Other Fixtures - Water Treating System
RE-PIPE:
TYPE oF EmmE QTY TYPE op FixTuAE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower —
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
How Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
La 210 Water Heater
V I
Other Rxhtras Water Trading System
MISCELLANMUS:
• Sewer Replaotsmusat o Back Flow Preventer o Grease Interceptor(Trap)_gallons(Requires 3sets o(plaits)
• Lawn Sprinkler System-Number of Heads cl Well
**SJRWD Well Completion Form.ComplewJTO-m—to be submitted todENBEhEig Department hr final inspection.—
o Other
permit becorrim;void l(woule dam notmmemmw within&six month period or work is suspended orabandoned flarsix mooths.I hereby cerdl�that I have read
(his application and knowthe same to be true and correct. All provisions of lam and ordinances governing this work will be oemplied with whether specified
ornot The pamilt does not S[w authority to violme the provislotts ofany other3tate or load law regulation construction or the performance of
Property Owners Name 51 DormcrCDL LLC Phone Number—204-686-4818
Plumbing Company Calmon Plumbing Inc Office Phone 904-744-6350 ax 904,551-QJ16_
to. Address: 1718 E Church Street City Awksmole State EL Zip 32202
License Holder(Print): Ofin Cannon-State Certification/Registration CFC1426IN
Notarized Signature 0�fLlcea=Holder
* LESU�- VFFi4A322 Sworn and subscribed before toe this 15 day of August 20-IL
c"mlss�
23 2018
MEJ Signature of Notary Public 4aaa�42�
Cash Register Receipt Receipt Number
City of Atlantic Beach R2314
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $569.90
PLRS17-0077 Address:47 DONNER APN: 172064 0000 $157.30
PLUMBING $15100
3 BASE FEE 5� j21022 $5500
PLUMBING FIXTURES 455=2332 �00 $98-00
STATE SURC14ARGES $4.30
STATE DEEP SURCHARGE 0000-208-0600 0 $2.30
STATE DCA SURCHARGE L,51�-500002080700 0 $2.00
PLRS17-0078 Address: 57 DONNER RD APN: 172064 0010 $157.30
PLUMBING $153.00
PLUMBING BASE FEE 2'�-;0;02 1000 $55.00
,;, 0 E'2000 14 $98.00
PLUMBING FIXTURES �322
STATE SURCHARGES $4.30
5"0 -208-7 0 $2.30
O:D
0 0
S STATE DCA SURCHARGE --]�45500002080770 $2.00
TATE DBPR SURCHARGE
PLRS17-0080 Address:55 DONNER RD APN:�172064 0020 $157.30
PLUMBING $153.00
PLUMBING BASE FEE S�LDOE 0- $55.00
PLUMBING FMURES :5S 5 N22M TI $98.w
STATESURCHARGES $4.30
STATE DBPR SURCHARGE 455-0000-208-0600 0 30
455000020go7nn 0
STATE DCA SURCHARGE :2 00
PLRS17-0081 Address:49 DONNER RD APN:�72064 0000 $98.00
PLUMBING $98.00
PLUMBING FIXTURES I 455-oi:0�322-Qg_l 14 1 $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
Pnnted:Wednesday,August 16,2017 2:01 PM 1 Of 1
CITY OF ATWIC78EACH
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8W SEMMOLE RD
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SEQ#: =MM2366
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INVOICE 427
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SkEAMOUNT
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