705 AMBERJACK LN - PLUMBING CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
, ATLANTIC BEACH,- ._. _. . _. ..FL 32233
, INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
i
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0135
Description: 11 FIXTURES
Estimated Value: 0
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 705 AMBERJACK LN
RE Number: 171193 0000
PROPERTY OWNER:
Name: SALT AIR HOMES INC
Address: 226 TALLWOOD RI
JACKSONVILLE BE CH, FL 32250
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: CANNON PLUMB! G, INC.
Address: 1794 -1002 ROGE-O RD QA OLIN MARSHALL CANNON
JACKSONVILLE, F 32211
Phone:
PERMIT INFORMATION:
Please see attached conditions of approv-1.
WARNING TO OWNER: YOUR FAIL ' ' TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT I ' YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPE TY. A NOTICE OF
COMMENCEMENT MUST BE RECO ° I ED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECT ION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YO ' LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTI S E OF COMMENCEMENT.
* A notice of Commencement is only required or work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commen ement is only required when HVAC work
exceeds and estimated value of$7,500.
- i
PLUMBING PE IT APPLICATION ��
CITY OF ATE NTIC BEACH 9 L d
800 Seminole Rd Atla tic Beach, FL 32233 ase4 1-1-
CSi kg .
Ph(904) 247-5826 F x(904) 247-5845
Jon ADDRESS: c25 5". _A vYil,e-r j a,G/ ! a rie-- PERMIT# •
NEW OR REPLACEMENT INSTALLATION: P oject Value$ 3cp#oesA a p'
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTJ'
Bathtub 1 Septic Tank&Pit .
Clothes Washer 1 Shower 1 •
Dishwasher Shower Pan
--
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 2
Hose Bibs 1 Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray Water Connected Appliances 1
Lavatory 2Water Heater 1�
Other Fixtures • .. Water Treating System
RE-PIPE: �\�
•
TYPE OF FIXTURE 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
Other Fixtures Water Treating System
MISCELLANEOUS:
o Sewer Replacement 0 Back Flow Preventer ❑ Greas i Interceptor(Trap) gallons(Requires 3 sets of pians)
❑ Lawn Sprinkler System-Number of Heads j 0 Well CC
**SJRWD Well Completion Form. Completed form to be s omitted to the Building Department for final inspection.**
❑ Other 6 CCtC-e-i► .Car,tk s r\ • . A , 1 nk_,• Cf:YY4
— 41111=1111•Permit becomes void if work does not commence within a six month period or ark is suspended or abandoned for six months.I hereby certify that Iat I have
this application and know the same to be true and correct. AU provisions of law.land ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to violate the provisions daily other state or local law regulation construction or the performance of construction.
Property Owners Name Salt Air Homes Inc Phone Number
Plumbing Company Cannon Plumbint Inc Office Phone 904-744-6350 Fax: 904-551-0416
Co. Address: 1718 E Church Street City Jacksonville S ate FL Zip 32202
License Holder(Print): ' Olin Cannon State Cer'tification/Registration# CFC1426140
Notarized Signature of License Holder
rP � LESLIE PALE FF 144322 Swoxxi and subscribed before me this A' day of Oa-01)w r" 20 11
:�
:, :, Expires July 23 2018
`',As; Bannon Thu Tray FinlnJnnntMa$5.70 Signature of Notary Public. �
5ligf
? : Cash Register Receipt Receipt Number
` City of Atlantic Beach R3302
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $136.00
PLRS17-0135 Address: 705 AMBERJACK LN APN: 171193 0000 $136.00
PLUMBING $132:00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 11 $77.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R3302 $136.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
•
ATLANTIC BEAC,FL 32233 15 34:41
10/27/2017
CREDIT CARD
VISA SALE
Card# �W�tX9974
10
SEQ#: 472
` Batch#: 10
INVOICE 032143
Approval Code: Manual
Entry Method: Online
Mode: $0,00
Tax Amount: M
Card Code:
SALE AMOUNT $136.00
CUSTOMER COPY
•
Date Paid: Friday, October 27, 2017
I
Paid By: CANNON PLUMBING, INC. j
Cashier: BA
Pay Method: CREDIT CARD 10 i
/g®
Printed: Friday,October 27,2017 3:36 PM 1 of 1 i
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