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53 Donner Rd plbg permit ,S 'r f CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 PLUMBING RESIDENTIAL - MUST CALL BY 4113M FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: PLRS17-0158 Description: 12 FIXTURES Estimated Value: 0 Issue Date: 11/30/2017 Expiration Date: 5/29/2018 PROPERTY ADDRESS: Address: 53 DONNER RD RE Number: 172064 0000 PROPERTY OWNER: Name: 51 DONNERCDL LLC Address: 355 11TH ST ATLANTIC BEACH, FL 32233 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: CANNON PLUMBING, INC. Address: 1794 -1002 ROGERO RD QA OLIN MARSHALL CANNON JACKSONVILLE, FL 32211 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 PERMIT APPLICATION CITY QIP' ATLANTICBEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 247-5826 Fax(904) 247-5845 PARS 1-7_ dA SE JOB Awwss: 53 DONNER ROAD PERMIT# RESI7-0052 NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE of FIXTURE QTY TYPE of FixTuRF QTY Bathtub 1 Septic Tank&Pit Clothes Washer 1 Shower I Dishwasher Shower Pan Drinking FountainSlop Sink Floor Drain Three Compartment Sink Floor Sink Toilet 3 Hose Bibs 1 Urinal Kitchen Sink l Vacuum Breakers Laundry Fray Water Connected Appliances Lavatory 3 Water Heater l Other Fixtures Water Treating System RE-PIPE; F,t \ TYPE of um QTY TYPE of FaTuRE 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: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Wrap) gallons(Requires 3 sets oi<plans) ❑ Lawn Sprinkler System-Number of Heads ❑ Well *n SJRWD Well Completion,Form. Completed form to be. submitted to the Building Department for final inspection.** ❑ Other New construction horde Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name Phone Number Plumbing Company Cantron Plumbing Inc Office Phone 904-744-6350 Fax 904--551-0416 Co. Address. 1718 E Church Street, City Jacksonville State FL Zip 32202 License Holder(Print): Olin Cannon State Certification/Registration#CFC1426140 Notarized Signature .bolderLmle Comm Dlon#FF 144322 Sworn and subscribed before me this 44A day of Nw*�&.r. 20 /'] , r Exp1Ty�wn3'^2018".to,e i�:� ✓/ Signature of Notary Public Cash Receipt • Register • City of Atlantic Beach R3574 DESCRIPTION • QTY PAID PermitTRAK $286.18 PLRS17-0157 Address: 51 DONNER RD APN: 172064 0000 $143.09 PLUMBING $139.00 PLUMBING BASE FEE 455-0000-322-1000 0 $55.00 PLUMBING FIXTURES 455-0000-322-1000 12 $84.00 STATE SURCHARGES $4.09 STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.09 STATE DCA SURCHARGE 45500002080700 0 $2.00 PLRS17-0158 Address: 53 DONNER RD APN: 172064 0000 $143.09 PLUMBING $139.00 PLUMBING BASE FEE 455-0000-322-1000 0 $55.00 PLUMBING FIXTURES 455-0000-322-1000 12 $84.00 STATE SURCHARGES $4.09 STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.09 STATE DCA SURCHARGE 45500002080700 0 $2.00 TOTALPAID BY RECEIPT: : . .18 CITY OF ATLANTIC BEACH 800 SEMINOLE RD ATLANTIC BEAC,FL 32233 11,30 2017 16:13:16 CREDIT CARD VISA SALE Card WXXXXXXXXX9974 SEQ 9: 6 Batch;: 493 INVOICE 6 Approval Code: 051447 Entry Method: Manual Mode: Online Tax Amount: $0.00 Card Code: M SALE AMOUNT $286,18 Date Paid:Thursday, November 30, 2017 Paid By: 51 DONNERCDL LLC CUSTOMER COPY Cashier: BA Pay Method: CREDIT CARD 6 Printed:Thursday, November 30,2017 4:15 PM 1 of 1 T TMIOT