1672 ATLANTIC BEACH DR-PLUMBING "'bj 1j
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
I ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE,247-5814,
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMA77ON:
PERMIT NO: PLRS18-0080
Description: install 26 fixtures
Estimated Value: 8000
Issue Date: 4/2/2018
Expiration Date: 9/29/2018
PROPERTY ADDRESS:
Address: 1672 ATLANTIC BEACH DR
RE Number: 1695051725
PROPERTY OWNER:
Name: RIVERSIDE HOMES OF N FL
Address: 414 OLD HARD RD STE 502
ORANGE PARK, FL 32003
GENERAL CONTRACrOR INFORMATION:
Name:
Address:
Phone:
Name: NELSON PLUMBING CO. INC.
Address: 11624 -1 DAV E DAVIS CREEK RD QA SCOTT GARY NELSON
JACKSONVILLE, FL 32256
Phone:
PERMIT INFORMATION:
It
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$7,500.
PLUMBING PERMrr APPLICATION
CITY OF ATLANTIC MACIE1
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 Pc�'V_si v000-
JoBADDPjLqs:. W7JI A_ILAWT�C_ &-mr-t-t PERMFT P,.Gc,IS-002
NEW OR REPILACKMENT INSTAMATION: Project Value$ q 0(D 0
TYPE oF FD xuRE QTY TYPEoFFDjvP.E QYY
Bathtub S
Ste Tank&Pit
Clothes Washer er
Dishwasher ShowerPan
Drinking Fountain Slop Sink
Floor Drain Three Compartment S,ink
Floor Sink Toilet q
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Lziumdry Tmy Water Connected Appliances I
Water Heater 2-
=Frh"dures Water Treating System I
RE-PIEPE:
TYPE oF FvavRE QTY T.YpEopFnaum QTY
Baffitub Septic Tank-&Pit
Clothes Washer Shower
Dishwasher S%wer Pan
Drinking Fountain Slop Sink
FloorDrain Three Compartment Sink
Floor Sink Toilet
I-lose BI
is Urinal
Kitchen Sink Vacuum.Breakers
Laundry Tray Water Comected Appliances
Lavatory Water Heater
R Water Treating System
MISCELLANEOUS:
o Sewer Replacement o Back Flow Preventer o Grease Interceptor(Trap) gallons(Requires 3 sets of pig
o Lawn Spriolder System-Number of Heads 0 Well
SJIZWD Well ConWlefion Forin. Completed form to be submitted to the RM—mg Department for final inspectior
o Other
Permit becomes void Xwork does not commence within a six month period or work is suspended or abandoned for six inorift I hereby certify tliat I have
diis application and know ft same to be true and corTem All provisions of laws and ordinances gDverumg this waik will be complied with whether specii
or noL The permit does not givo authority to violatc the provisions of any other state or local law regulation construction or the pert6rmance,of constructic
ProperLy Owners Name VE rue.-.I D C Ho m GF1 Phone Number
Plumbing Co*any -Al E6 C 0 W ft-(_4 M 6;W 6 C4 T�a --Office Phone 26 Z. q 0 L'( Fa,�..
Co.Address: I)At1h (t2eeetL �T� 15� city,aftc LrOK State L_Zip :Z22
License Holder(Print); grD 7-1 caflon/Regis:tration 6243 77
ca'i'
Holder
41 M M. #
EXPIRES:November 16.2019
Tnne clay o�f 201
OF
Bonded Thru Notxy Pubfio Undemftrs Swom and st �.fhre
Signature ofNotary Public
Cash Register Receipt Receipt Number
City of Atlantic Beach R4668
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK
$242.93
PLRS18-0086. Address:.1672 ATLANTIC BEACH DR APN: 1695051725,
$242,93
PLUMBING _$237.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 26 $182.00
-SURCHARGES -
STATE
$5.93
STATE DBPR SURCHARGE 455-0000-208-0600 0 $3.56
STATE DCA SU RCHARG E 45500002080700 0 $2.37
TOTAL FEES PAID BY RECEIPT: R4668 $242.93
CD 7-0
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Date Paid: Monday,April 02, 2018
Paid By: NELSON PLUMBING CO. INC.
Cashier: CB
Pay Method: CREDIT CARD 00817g
Printed: Monday,April 02,2018 2:33 PIVI
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