49 Donner Rd plbg permit (2) CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0081
Description: 14 FIXTURES
Estimated Value: 0
Issue Date:
Expiration Date;
PROPERTY ADDRESS:
Address: 49 DONNER RD
RE Number. 1720640000
PROPERTYOWNER:
Name: LYLES TOMMY
Address: 13925 HUNTERWOOD RD
JACKSONVILLE, FL 32225-1905
GENERAL CONTRACTOR INFORMATION:
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 HVAC work
exceeds and estimated value of$7,500.
PLUMBING PERAUT APPLICATION
CITY oF ATLANTic BEAcfl
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5945
JOB ADDRESS: 1+1 DoNNERRoAv PKRM1T#
NEW OR REPLACEMENT INSTALLATION: Project Value$ 3000.00
TYPEoFFIXmite Q77 TYPEOFFIX51VRE QTY
Bathtub I Tank&Pit
Clothes Washer I rhower
Dishwasher I— Shower Pan I—
Drinking Fountain SW&k,
Fluor Drain T partimarit Sink
Floor Sink Toilet
How Bibs I— Urinal
Kitchen Sink I— Vacuum Breakers
Laundry Tray Water Connected Applianous
Lavatory Water Heater
Other Fixtures Water Treating System
RE,PIPE:
TYFEOFPDUVRE QTY Time oF FixTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher ShowerPan
Drinking Fountain Slop Sink
FloorDrain Three Compartment Sink
floor Sink Toilet
How Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Leveling Water Heatur
Other Fixtures Water Treating System
MISCELLANEOUS:
in Sewer Replacement u Back Flow Preventer El Grasse Interceptor(rrap) Sallow;(Requires 3 sets of plans)
:3 Lawn Sprinkler Systern-Number of Heads C Well
**SJRWD Well Completion Form. Completed form to be submintedto&-gu-TiEng Department for final inspection."
D Other
Pennitbeconves void if warkdow notconnatence within&six mouth period or work is suspended orabandonadforsix,man&,.I hereby certify that I have
this application and know the serno to be true and conecit. All provision of lam and ordinances gorveratiog this work will be complird with wbetherspecificil
or not. The Parnell does not givc authority to violate the provisions of a"otbc�state or local law pagulaom construction or the puinmance of construction.
Property Ownm Name 5 1 DonnerCDL LLC Phone Number 904-686:A818
Plumbing Company Clanton Plumbing Inc --Office Phone 904-744-05�LFax 904-551-0416
Co. Address: 1718 E Church Street City Jacksonville state F Zip 32202
License Holder(Pont): Olin Cannon-State Cedification/Registration# CFC1426140
Notarized Signature ofLkense Holder
Sworn and subscribed beibre me this 15 dayrof AWN—t 20-IL
LESLIE DALE
convid"RaFV144322
Signature of Notary Public
41,9
Cash Register Receipt Receipt Number
12 City of Atlantic Beach R2314
DESCRIPTION ACCOUNT CITY PAI D
Perni $569.90
PLRS17-0077 Address: 47 DONNER APN: 172064 0000 $157.30
PLUMBING $153.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-OOOD-322-1000 14 $98.00
STATE SURCHARGES $4.30
STATE DBPR SURCHARGE 455-OWD-2W 0600 0 $2.30
STATE DCA SURCHARGE 45500002080700 0 $2.00
PLRS17-0078 Address: 57 DONNER RD APN: 172064 0010 $157.30
PLUMBING $153.00
PLUMBING BASE FEE 455-0000-322-1000 0
PLUMBING FIXTURES 455-0000-322-1000 14 $98.W
STATE SURCHARGES $4.30
STATE DEER SURCHARGE 455-GOOG-208-0600 $2.30
STATE DCA SURCHARGE 45500002080700 00 $200
PLRS17-0080 Address: 55 DONNER RD APN: 172064 0010 $157.30
PLUMBING $153.00
PLUMBING BASE FEE 455 0000 322 1000 0 $55.00
PLUMBING FIXTURES 1 455 0000-322-1000 14 $98.00
STATE SURCHARGES $4.30
STATE DBPR SURCHARGE 455-000�208-06ffl $2.30
STATE DCA SURCHARGE 45500002080700 00 $1W
PLRS17-Ml Address:49 DONNER RD APN� 172064 0000 $98.00
PLUMBING $98.00
PLUMBING FIXTURES 455-00�322-1000 14 $99.00
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 I
aTY OF ATLANTIC BEACH
BDO SIMILE RD
ATLANTIC BEAC,Fl.32233
0811612017 13:5554
CREDIT CARD
VISA SALE
(ad P )O=)ZW2366
SEQ 3
W#: 427
INNOICE 3
3
7
3
Apovat Cude: 021887
bty Method. mnjwi
Online
Tax Arfad: $D00
14
card W� m
SALE AMOUNT pqx
CUSTOMER COPY