330 Royal Palms PLRS18-0174 Cash
Register
Receipt Receipt . ,Number
City
f Atlantic Beach
DESCRIPTION ACCOUN7''jQTy PAID
PermitTRAK $59.00
PLR518-0174 Address: 330 ROYAL PALMS DR APN: 171708 0000 $59.00
$ss.00
PLUMBING
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
$4.00
STATE SURCHARGES
STATE DBPRSURCHARGE 45S-0000.20&0700
00- 0 $2.00
STATE DCA SURCHARGE 455-00208-0600 0 $200
TOTAL • BY RECEIPT: 1 $59.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,R 32233
07/31/2018 13:46:00
CREDIT CARD
MC SALE
Cad q IIXgCY%XLipp(8193
SEQ A: 7
wt 669
INVOICE 7
Approval Code: 043373
Entry Mem: Maual
Mode: Onlhe
Taw Anl•tA: $0.00
Ow Code:
Cad Code: M
SALE AMOUNT ROO
CUSTOMER COLO'
Date Paid:Tuesday,July 31, 2018
Paid By: ROTO ROOTER SERVICES
Cashier: BA
Pay Method: CREDIT CARD 7
Printed:Tuesday,July 31,20181:48 PM 1 of 1
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 1111FORMATION:
PERMIT NO: PLRS18-0174
Description: Sewer Replacement
Estimated Value: 1500
Issue Date: 7/31/2018
Expiration Date: 1/27/2019
PROPERTY ADDRESS:
Address; 330 ROYAL PALMS DR
RE Number: 171708 0000
PROPERR:
Name: ROLLANS RACHEL
Name:
Address: 330 ROYAL ATLANTIC BEA PALMS DR
32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: ROTO ROOTER SERVICES
Address: 2028 W 21 ST ST 2028 W 21 ST ST
JACKSONVILLE, FL 32203
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
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 ('�F
JOB ADDRESS: 330 Royal Palms Driver, Atlantic Beach, FL 32233 PERMIT#LUA/t7-tet 7
NEW OR REPLACEMENT INSTALLATION: Project Value S 1.500.00
TYPE OF FIXTURE QTY TYPE OF FixTURE 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 _
RE-PIPE:
TYPEOFFIXTURE QTY TYPE OF FIXTURE 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:
'x Sewer Replacement ❑ Back Flow Preventer Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Lawn Sprinkler System-Number of Heads % Well "
-" VRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
Other
Permit bi: it)n void if work does to wmmenw wdhm n sx month penod or work is suspended m abandoned for six 11 t,e o.I h reby o that I h d
this nt. The fe aM know l give
a to n we atd cortre p NI provisions other and ordinances goveming this souk will M ce perfor with xf was spcti a.
orrent. The permit does nal give authmiry m violate the provisions of any other smm or local low rcguletien wnstmdion or the performanw of wnsw%inn.
Property Owners Name Spencer Thomas Phone Number 817.692-3626
Plumbing Company
Roto Rooter-Robert Mason Office Phone 9oa-354-7321 x 21900 Fax 90a-35a9255
Co.Address: 2028 west 21st street City Jacksonville State FL Zip 32209
License Holder(Print): RotertMason /�/ State Certification/Registration# CFC 1420143
Notarized Signature of License Holder
Swom and subscribed befo me thi 30 d, orpl f July 20 ie
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Caanbnnt9d 211705 Signature of Notary Public �---
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