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1761 Sea Oats Dr PLRS18-0128 CITY OF ATLANTIC BEACH ss1 800 SEMINOLE ROAD _ATLANTIC BEACH,FL 3223_3 �! ,-"3iT %' } INSPECTION PHONE LINE 247-5814 PLUMBING RESIDENTIAL - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: PLRS18-0128 Description: install 5 fixtures Estimated Value: 2000 Issue Date: 5/16/2018 Expiration Date: 11/12/2018 PROPERTY ADDRESS: Address: 1761 SEA OATS DR RE Number: 172020 0446 PROPERTY OWNER: Name: TODD WELLS L Address: 1761 SEA OATS DR ATLANTIC BEACH, FL 32233-5828 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: A TO Z CONTRACTING AND PLUMB Address: 406 HAMLET RD BRETT ALAN THOMAS JACKSONVILLE, FL 32221 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$7,500. PLUMBING PERMIT APPLICATION K65 CITY OF ATLANTIC BEACH A-/%-Oac�0 800 Seminole Rd Atlantic Beach,FL 32233 Ph(904) 247-5826 Fax (904)247-5845 JoB ADDRESS: �.1-s�G4 a��S .�i� +PERMiT# NEW OR REPLACEMENT INSTALLATION: Project Value$ 2 000, U TYPE of FIXTuRE QTY TYPE of Fixmm QTY Bathtub Septic Tank&Pit Clothes Washer _� Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Z Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System RE-PIPE: TYPE oFFIXTURE QTY TYPE oFFIXTURE 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 Sprinkler System-Number of Heads ❑ Well **SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.** ❑ Other 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 D \Qe.k Phone Number Plumbing Companyr:::)±6l Z ri�!/0_wf Office Phone,311/60/ FaxoL/JQV L/a2 Co. Address: City Stat Zip32 Z Z/ License Holder(Print): tt C s State Certification/Registration ACF Notarized Signature of License Holder til Sworn and subscribed before me this day of r--,l 20kf,ti v WON Public State of Florida n Sean c Harkenreader Signature of Notary Public W_ 'my commission GG 199327 1 I #Xpires 0310912022 or _J Register Receipt Receipt Number Cash City ofAtlanticBeach R512• DESCRIPTION ACCOUNTCITY PAID PermitTRAK $55.00 PLRS18-0128 Address: 1761 SEA OATS DR APN: 172020 0446 $55.00 PLUMBING ROUGH 05/17/2018 RBE $55.00 PLUMBING ROUGH 05/17/2018 RBE 45500003221002 1 0 $55.00 ':TOTAL FEES ' 11 CITY OF ATLANTIC BEACH 800 SEMINOLE RD ATLANTIC BEAC,FL 32233 05,,21/2018 15:28:38 CREDIT WD VISA SALT: {:ARD# :m(X)0(XXXXX7175 INVOICE 0012 :;EQ#: 0010 F;attll#: 000802 Ipproval Code: 172380 :ntry Method: Manual lode: Online Tax Amount. $0.00 :.ard Code: M :;ALE AMOUNT 5551 CUSTOMER COPY Date Paid: Monday, May 21, 2018 Paid By: A TO Z CONTRACTING AND PLUMB Cashier: CB Pay Method: CREDIT CARD 172380 /0% Printed: Monday, May 21,2018 3:30 PM 1 of 1 1 T"T