1895 Atlantic Beach Dr plbg permit r CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
"!Oil >r INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0075
Description: install 21 fixtures
Estimated Value: 0
Issue Date: 3/28/2018
Expiration Date: 9/24/2018
PROPERTY ADDRESS:
Address: 1895 ATLANTIC BEACH DR
RE Number: 169505 1580
PROPERTY OWNER:
Name: ATLANTIC BEACH PARTNERS LLC
Address: 414 OLD HARTS RD STE 502
FLEMING ISLAND, FL 32003
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: DARLEYS PLUMBING INC.
Address: 4472 PHILLIPS HWY QA CARL LESLIE DARLEY
JACKSONVILLE, FL 32207
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$7,500.
ai
PLUMBING PERMIT APPLICATION
CITY OF ATLA►.NTiC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph (904) 247-5-826 Fax(904)247-5845 �L j2S l
JoB•AADRESS: 615r k r .0 I1fhce Qin.. PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FjxruRE QTY TYPE o.F,FIXTURE Qr'
Bathtub 3 Septic Tank& pit
Clothes Washer Shower f
Dishwasber i Shower Pan
Drinking Fountain Slop Sink
Floor brain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs t-- Urinal
Kitchen Sink r Vacuum Breakers
Laundry Tray Water Connected Appliances 71.
Lavatory q Water Heater {_
Other Fixtures Water Treating System I
RE-PIPE:
TYPE OF FIXTURE QTY TYPE OF FfXTURE 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
i,,aundry Tray _ Water Connected Appliances
Lavatory Water Heater
Other Fixtures _ Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement 0 Back Flow Preventer Li Grease Interceptor(Trap) gallons(Requires 3 sets of ptaos)
o Lawn Sprinkler System-Number of Heads n Well **
**,SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
n Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned ror six months.I hereby certify that]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 pot•fbrmance of construction,
Property Owners Name Phone Number
Plumbing Company,�AR.J*„t 1 /�c.-"&'2Z*'� Office phone -7'1-?-/y MY Fax 7L7 -/Y�S�
Co. Address: y-> City 7Afte State Fe_ Zip ;�2.i-a'5
License Holder(Print): State Certification/Registration# �a S'G7°2
Notarized Signature of License Folder
/ �t� 20 IS
`pMP�yH JOANNE MEHL worn and subscribed before this --day of __-_
's Nolaty public-Slate of Florida
.• Commatllon#QQ 021751 ignature of Notary Public
My Comm.Expires Aug 29,2020
..... Bonded Through Whonat Notary Assn.
3 rS'yL`IrjV
J Cash
City ofAtlanticBeach R4617
DESCRIPTION • CITY PAID
PermitTRAK $435.63
PLRS18-0074 Address: 1774 ATLANTIC BEACH DR APN: 169505 1640 $228.58
PLUMBING $223.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 24 $168.00
STATE SURCHARGES $5.58
STATE DBPR SURCHARGE 455-0000-208-0600 0 $3.35
STATE DCA SURCHARGE 45500002080700 0 $2.23
PLRS18-0075 Address: 1895 ATLANTIC BEACH DR APN: 169505 1580 $207.05
PLUMBING $202.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 21 $147.00
STATE SURCHARGES $5.05
STATE DBPR SURCHARGE 455-0000-208-0600 0 $3.03
STATE DCA SURCHARGE 45500002080700 1 0 $2.02
'TOTALPAID BY RECEIPT: . • $435.63
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
03/28/2018 09:53:54
CREDIT CARD
VISA SALE
Card# XXXX10000(XXX1437
SEQ#: 1
Batch#: 572
INVOICE 1
Approval Code: 00639G
Entry Method: Manual
Mode: Online
Tax Amount: $0.00
Card Code: M
Date Paid: Wednesday, March 28, 2018 SALE AMOUNT 35,63
Paid By: DARLEYS PLUMBING INC.
Cashier: BA
CUSTOMER COPY
Pay Method: CREDIT CARD 1
Printed:Wednesday, March 28, 2018 10:06 AM 1 of 1 A
MMT