22 Seminole Rd PLRS18-0241 grease trap permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS18-0241
800 SEMINOLE ROAD ISSUED:
91 EXPIRES:
ATLANTIC BEACH. Fl.32233
MUST LCALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALLWIAK MYST CINFERM TI;THE CYRRENT fTH E31ITIVII (2117) #F THE FLIRIIARUILI*jc�
CODE, NEC, IPIVIC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
o 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,orfederal agencies.
JOB ADDRESS: PERMITTYPE: DESCRIPTION: VALUEOFWRORK:
22 SEMINOLE RD PLUMBING RESIDENTIAL Grease Trap Repair $200.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1706550000 SALTAIR SEC 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
TOUCHTON PLUMBING 416 N RYAN AVE JACKSONVILLE ILL 32254
OWNER: ADDRESS: CITY: STATE: ZIP:
DORSCH SALTAIR PO BOX 404 PENNEY FARMS FIL 32079
PROPERTIES LLC
NOTICE: In addition I he Bq.ire e emai"here may beadd itic"'a I restrictions applicable to this I
e ay
FIR
B B.1 pBr�
its required�
t OTI ma- In a I.iti tI,to t r C re m r nt'of til is P u B e from th
that may be found in the P.bl c. d'of this Go n I y,a cl tsh r m be dditi.
g.vBrnmeSta I tU s Sac a,wat m n.ge t s rict', tate gBnci s,or Bral agences.
governmental entitle In er a men di a e fed
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DES RIPTION ACCOUNT QUANTITY PAID AMOUNT
FLU NG BASE FEE 455 0000-322 1000 0 $55'w
Mal
PLUMBING FIDCTURES 4SS-0000�322 10M 0 Saw
STATE DERR SURCHARGE 455 000)208 07W 0 $2.49
455 OCKU-208-0500 0 $2,00
455 MO-322-1000 0 $110,00
I TOTAL:$169.48
issued Date:
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: Z. S&AP - A Rwr# 7
"ooste .0- 9;r4,*AoX_r0 fA#CAV4..PE
NEW OR REPLACEMENT INSTALLATION: ProjectValluee
TYPE OF FixTuRE TYPE OF FaTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Stop Sink
Floor Drum Three Compartment Sink
Fluor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacmun Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating Sysom
RE-PIPE:
TYPEoFFLY7vRE QTF TyFEoFDxruRE QIT
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
How Bibs urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures, Water Treating System
MISCELLANEOUS: 7n" b,�
r,rop d;r Z 70 0-2 9- 't r-dpm,
Ei Sevver Replacement (3 Back Flow Preverattar ig Grease Interceptor(Trup) 5b Ill) gallons Motivations 3 sets of plans)
0 Lavat Spnnklesr System-Number of Heads cl Well
**SIRWD Well Completion Form.CouripleteFf—ormtobe submittesito Ge—Building Department for final inspection."
o other
permit becomes void if work does not commersce within a six month period or wosk is suspooded or abandoned for six months.I hereby certify that I haw read
this application and know the same to be arms and correct. All provislono of hm and ordinancet governing this work will be compiled with whetbe,specified
or not The permit does not give authority to violate the pm,wom,of my other state or local tow orgmation on,bection or the performance of construction.
Property Owners Name 7WV eyqr4,,ytp PhoneNumber eeS'S--4S13
Plumbing Company 7_0,WC,4'70,V PkAeNd, ____OfBce Phone Dj-&" Fax3kt�,9-pl?,
Co. Address: 4W 9-4AN) -AUC city l;rA x State F—L ZIP 3-21
License Holder(Print): L
CertificnitimalRegistratio,#e, C- V
Notarized Signature of License Holder
OPP.%
SHERRYKAYES
onril"n#031"worn and subscribed betore mdthis 11 -"' dayofQQ,�Qbe_t` 2Qjj_
UP1nuMan%3.2:jW.tmcofN,ta,yp,bji, V)j 04o,
Cash Register Receipt Receipt Number
City of Atlantic Beach R7042
DESCRIPTION
PermItTRAK $169.48
PLRSIB-0241 Address: 22 SEMINOLE RD APN: 170655 0000 $169.48
PLUMBING $55.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
STATE SURCHARGES $4.49
STATE DEER SURCHARGE $2.48
'0 0
E
STATE DCA SURCHARGE 4!15 0000012068-1Z20 0 $200
WORK WITHOUT PERMIT $110.00
WORK WITHOUT PERMIT 455-0000-322 1000 1 0 $110.00
TOTAL FEES PAID BY RECEIPT: R7042 $169.48
Date Paid: Monday, October 15, 2018
Paid By: DORSCH SALTAIR PROPERTIES LLC
Cashier: C13
Pay Method: CREDIT CARD 1322g
Printed:Monday,October 15,2018 10:04 AM 10fi It
Permit Inspections
City of Atlantic Beach
Permit Number: PLRS18-0241 Description:Grease Trap Repair
Applied: 10/12/2018 Approved: 10/15/2018 Site Address:22 SEMINOLE RD
Issued: Finaled: 10/16/2018 City,State Zip Code:Atlantic Beach,FI 32233
Status: FINALED Applicant:<N011
Parent Permit: Owner: DORSCH SALTAIR PROPERTIES LLC
Parent Project: Contractor:<NONE>
Details:
LIST OF INSPECTIONS
SEQ SCHEDULED DATE COMPLETED DATE TYPE INSPECTOR RESULT REMARKS
ID
10/16/2018 10/16/2018 PLUMBING Universal PASSED
FINAL" Engineering
Notes:
Mike
001%
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