1701 Selva Marina Dr. - Sewer Replacement Permit 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: 2,47-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0071
Description: Sewer Replacement
Estimated Value: 2500
Issue Date: 3/23/2018
Expiration Date: 9/19/2018
PROPERTY ADDRESS:
Address: 1701 SELVA MARINA DR
RE Number: 1720130000
PROPERTY OWNER:
Name: STER JOHN W
Address: 1701 SELVA MARINA DR
ATLANTIC BEACH, FIL 32233-5617
GENERAL CONTRACrOR INFOR14ATION:
Name:
Address:
Phone:
Name: BILL FENWICK PLUMBING
Address: 11623 E COLUMBIA PARK DR CIA WILLIAM K. FENWICK, JR
JACKSONVILLE, FL 32258
Phone:
PERMIT INFORMATION:
Please see attached oonditions 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 mquired 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.
Cash Register Receipt Receipt Numbe
19 City of Atlantic Beach R4596
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $66.00
PLRS18-0071 Address: 1701 SELVA MARINA DR APN: 172013 0000 $66.00
PLUMBING 56200
PLUMBING BASE FEE 455-0000-322-1000 1 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 1 1 $7.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-OWD-2DB-0600 1 0 $2.00
STATE DCA SURCHARGE 45500002080700 1 0
�TOTAL FEES PAID BY RECEIPT: R4596 $66.00
CITY OF ATWMC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,R.32233
03,'23/2018 16AS35
CREDIT CARD
VISA SALE
Cad )OC000(*=7527
SEQ A: a
W#: 569
INVOICE 8
Approval Cok: 7342BG
Biry MdW: Maui
Cl
Tax knit: $0.00
Card Code: M
SAUE AMOUNT
CUSTOMER COPY
Date Paid: Friday, March 23, 2018
Paid By: BILL FENWICK PLUMBING
Cashier: BA
Pay Method:CREDIT CARD 8
Printed:Friday,March 23,2018 4:16 PIVI I of 1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fu(904)247-5945
JOBADDRESS: 1--\C)\ 5f�X]Qk rIcAnm Dy- PEUM# FL99d-rM
NEW OR REPLACEMENT INSTALLATION: Project Value$ t2 ,500-0-1�:,
TYPE OF FixrvRr QTY TYPEOFFixTuRE Q"
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 Tmy Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPEOFFIXTURE Qry Titr OF FixTuRE Qry
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
Lavatory Water Heater
Other Fixtures Water Treating System
PPSCELLANEOUS:
Pewer Replacement 0 Back Flow Pneventer ri Grease Interceptor(Tmp) gallons(Requires 3 sets of plans)
0 Lawn Sprinkler System-Number of Heads — L Well
**,VRWD Well Completion Form. Completei form to be submitted to the Building Department for final inspection.--
a Other
Ponta txxxumm�oid if.orkdm not comaxonto itbin a six ollmh period or work is suspended or abandoned for six months.I hemloycerrilythm I lawcoad
thbaWtimimandknowthc�ctok�eudcomci, All novisions of laws and onlinames gocming this worl,will be emalnutd�iflh whether specified
or not. The fxrasil dcats not givc authority oli�T;�ions ofany other sol,or 1.1 law realshou contraction or the penformossone ofoarturustion.
--�Tz 32
Property Owners Name Phone NurnbarCb
Plumbing Company T�e"J�C Y_
Co. Address:I tl_Q -2'2 Cinlurr,,):�ct -D�r -C _/city 7:�0-y- StatcEL-Zip 31).
License Holder(Print): K ) I W.ru iC J_ State Certification/Registration#CX�C_041y)
Notarized Signature of License Holder fifd4tsiffid 1-2 R'D
ALEXANDRLA AC Swommad0loscribediLmle Is dayof ITUY(fi 20
tol.=21 Signature of Notary Public