1618 Atlantic Beach Dr PLRS18-0161 CITY OF ATLANTIC REACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NE)['r DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-O`16i
Description: WATER HEATER
Estimated value: 66
Issue Date: 7/5/2018
Expiration Date: 1/j/2019
PROPERTY ADDRESS:
Address: 1618 ATLANTIC BEACH DR
RE Number: 1695051125
pROpERfiMNER:
Name: RIVERSIDE HOMES OF NORTH FLORIDA INC
Address: 1227 SAN JOSE BLVD STE 120
JACKSONVILLE, FL 32223
GENERAL CONTRAcTOR INFORMATION:
Name:
Address:
Phone:
Name: AFFORDABLE WATER/KINDER INC
Address: 3760 KORI RD SPECIALTY WATER(CONS TDS QB)
JACKSONVILLE, FL 32257
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 a&cncies.
*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 BVAC work
exceeds and estimated value of$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,Fl,32233
Ph(904)247-5826 Fax(904)247-5845 PLPS 18 - b R�
&6 PERMIT#
JOB ADDRESS; I G 18AtLANTIC J3Car-h NiVe I ArLPNnc —
-A 27A a
NEW OR REPLACEMENT INSTALLATION: Project Value$ Co(o-00
TYPE oF FixTuRE Qry TYPE oF FixTURE QTY
Bathtub — Septic Tank&Pit
Clothes Washer — Shower
Dishwasher — Shower Pan
Drinking Fountain — Slop Sink
Fluor Drain Three Compartment Sink
Fluor Sink Toilet
How Bibs — Urinal Breakers
Kitchen Sink — Vacuum
Laundry Tray — Water Connected Appliances
Lavatory — Water Heater
Other Fixtures Water Treating System
REP1PE:
TYPE oF FixTuRE QTY TYPEorFjxTvRE QTY
Bathtub — Septic Tank St Pit
Clothes Washer — Shower
Dishwasher — Shower Pan
Drinking Fountain — Slop Sink
Floor Drain — Three Compartment Sink
Fluor Sink — Toilet
How Bibs — Urinal
Kitchen Sink Vacuum Breakers
— Water Connected Appliances
Laundry Tray — Water Heater
Lavatory —
Other Fixtures Water Treating System
AUSCELLANEOUS:
• Sewer Replacement 0 Back Flow Preventer Ej Grease Interceptor(Trap) gallons(Require;3 sets of plans)
• Lawn Sprinkler System-Number of Heads 11 Well
**SJRWD Well Completion Fom.Cornpleted-f—ormto be submitted to tfi�_Buildmg Department for fimal inspection."
o Other
Tejah becomes void if work does nol:wlamsm"within B six month period or work is suspended or abandoned for six months.I hereby oertify that I have read
,iceman and know the same to be eme and comet. An previsions oflaus and ordinances governing this work will be complied with whether specified
TZhe permit does not give authority to violate the provisions,of my other state,or local law regulation construction or the performance of constrection.
(q 0 4)3 3 q-19 9 S
Property owners Name M�Chae-1 LA &) iER Phone Number—
1104- 90
hone 0
Plumbing Company Arrokl>ABLE WATOP, -offi,,P — ax�O -
co.Address: Zri(po Kolzi 'ROaJ CityjAck_soi3�,11 stateEL zip 49.2-59
License Holder(Print): MORK A- K)NDEP- Statec fication/Registration# 000618�?
Notarized Signature of License Holder
Swom and subscribed be me .a dayof Juk�l 2016
Notayposies"d W /')'\ n I-t1f) A
Dwaft M.Dswx* Signature of Notary lic
Cash Register Receipt Receipt Number
11 City of Atlantic Beach R5576
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $66.00
PLRS18-0161 Address: 1618 ATLANTIC BEACH DR APN: 169505 1125 $66.00
PLUMBING $62GO
PLUMBING BASE FLI 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 455-0000-208-0600 52 00
STATE DCA SURCHARGE
TOTAL FEES PAID BY RECEIPT: R5576 $66.00
Date Paid:Thursday,July 05,2018
Paid By:AFFORDABLE WATER/KINDER INC
Cashier:CB
Pay Method: CHECK 55964
Printed:Thursday,July 05,2018 3:12 PM 1 Of 1 It