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2400 SEMINOLE RD - PERMIT PLRS18-0138 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: 247-5814 PERMIT INFORMATION: PERMIT NO: PLRS18-0138 Description: Install 40 Fixtures Estimated Value: 69000 Issue Date: 5/31/2018 Expiration Date: 11/27/2018 PROPERTY ADDRESS: Address: 2400 SEMINOLE RD RE Number: 168354 0000 PROPERTY OWNER: Name: GLOVER S TAYLOR Address: 133 LUCKIE ST ATLANTA, GA 30303 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: MIKE SANVILLE PLUMBING INC Address: 530 ELLIS RD STE 212 QA MICHAEL RAYMOND SANVILLEJI JACKSONVILLE, FL 32254 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 F RST 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 govemmental 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 Ph(904) 247-5826 Fax(904)247-5845 JOBADDRESS: Qvn-) MtY\IC)� e � PERMTTr Rp # NEW OR REPLACEMENT INSTALLATION: Project Values TYPE of FIXTURE QTY TYPE oFFfXTORE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Si Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System RE-PIPE: TYPEOFFfxTuRE 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 he we and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give autthhg/Zity ttoviolate the/provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name �/y 'e -'eh — SI l�l^M�J Phone Number Plumbing Company / / � Office Phone /t Fa01-7S k Co. Address: — r _ /2 City�G�State Zip ' License Holder(Print): /[ =Certificajon/Registration# �Smo Notarized Signature of License Holder v;}; JENMFERJOHNSTON Sworn and subscribed before me 's 31 day of Nctll, 20iL fter�� `v MY Caaala5lpNRGG d1Poa iv J e H V,020 Signature of Notary Public S n Cash Register Receipt Receipt Number . v City of Atlantic Beach 0. DESCRIPTION ACCOUNT PermitTRAK $343.38 PLR518-0138 Address: 2400 SEMINOLE RD APN: 1683540000 $343.38 PLUMBING $335.00 PLUMBING BASE FEE 455-0000-322-1000 0 $55.00 PLUMBING FIXTURES 455-0000-322-1000 40 $280.00 STATE SURCHARGES $8.38 STATE DBPR SURCHARGE4550000 00-208-06 0 STATE DCA SURCHARGE 45500002080]00 TOTAL FEES PAID BY RECEIPT: 1 . Date Paid:Thursday, May 31, 2018 Paid By:GATSBY LAND TRUST Cashier: CB Pay Method: CREDIT CARD 075744 Printed:Thursday, May 31,2018 12:44 PM 1 of 1