283 BELVEDERE ST - PLUMBING 1
` , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
'1'2,053 vP INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0048
Description: PLUMBING - 10 FIXTURES
Estimated Value: 0
Issue Date: 2/22/2018
Expiration Date: 8/21/2018
PROPERTY ADDRESS:
Address: 283 BELVEDERE ST
RE Number: 170502 0000
PROPERTY OWNER:
Name: JAX HOME PRO LLC and ELITE PROPERTY of NORTH FLORIDA
Address: 11271 KINGSLEY MANOR WAY
JACKSONVILLE, FL 32225
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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* 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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 R 5 ,.� ��
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: 283 BELVEDERE ST PERMIT#_
PcRs18 - oo46
NEW OR REPLACEMENT INSTALLATION: Project Value$ 000.roe
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
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
Lavatory 2 Water Heater 1
Other Fixtures Water Treating System
RE-PIPE: \U2 •
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:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinlder System-Nun-iber of Heads D Well *
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other new construction home
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 Hogar Community Reinvestment
Plumbing Company Cannon 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# CFC 1426140
Notarized Signature of License Holder
042, LESLIE DALE Sworn and subscribed before me this 16 day of February 20 18
Commlesion#FF 144322
Expire%mosPir July akk tots Signature of Notary Public
ooiMlOTlraTroy fdnlmrena00488rio19
, ----
,
t Cash Register Receipt Receipt Number
s,
' City of Atlantic Beach R4309
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $129.00
PLRS18-0048 Address: 283 BELVEDERE ST APN: 170502 0000 $129.00
PLUMBING $125.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 10 $70.00
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: R4309 $129.00
Date Paid: Wednesday, February 21, 2018
Paid By: CANNON PLUMBING, INC.
Cashier: CB
Pay Method: CREDIT CARD 061271
1,..
Printed:Wednesday, February 21,2018 3:27 PM 1 of 1 In
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