1709 Atlantic Beach PLRS18-0254 PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
goo Seminole Rd Atlantic Beach. Fl 322""
1-- 5 - 02
Ph (904) 247-5826 Fax (904) n4i �84�
P RIMIT#
JOBADDRESS:_1,109 11ki 'liou" Pkk_ �
NEW OR REPLACEMENT INSTALLATION: Project Value$ QTY
TYPE OF FIXTURE QTY TYPE OF FIXTI RE
Tank& Pit
Bhuhtub Septic
Shower
Clothes Washer Shower Pan
Dishwasher Slop Sink
Drinking Fountain Three Compartment Sink
Floor Drain Toilet
Floor Sink Urinal
Hose Bibs vacuum Breakers
Kitchen Sink Water Connected Appliances
Laundry Tr-
\k ater Heater Lyz�
La%atory \k ater Treating Sy stem
other Fixtures
RE-PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTt RE QrY
Septic Tank & Pit —
Bathtub — Shower —
Clothes Washer — Shower Pan —
Dishwasher — Stop Sink —
Drinking Fountain — Three Compartment Sink
Floor Drain — Toilet
Floor Sink — Urinal
Hose Bibs — Vacuum Breakers
Kitchen Sink — \k ater Connected Appliances
Laundry Tray — Water Heater
Lavatory — \k ater Treating Svstem
Other Fixtures
MISCELLANEOUS: lot (Trap) gallons(Requires 3 sets of Phe
j Sewer Replacement Aack Flow Preventer Grease Intercep
Lawn Sprinkler System-Number ofHeads - Well ent for final inspectiOr
SJRWD Well Completion Form. Completea--form to be submitted to the—Building Departm
Other
Perninit bewricr void if work does no!commerce within 7,ix',;dnthperiOd Or Work is susPended or abandoned for six m7lis.I—hembY certit that i have
this application and know the vore to be true and comer, All provisions of laws and ondin...e,g.,erring this work will be compliOd with.1bether spcci
or not. The pernit does not give atthorir� in%iolatc the provisiom of an% other lone o"n"'law enntroc....n or the perlorroinct Of ton'"'nah
�, bj� Phone Number 'XI-7-865b
Property Owners Name _\3A,5.5 _1D
PlumbingComp,my, office Phone'JO'A Fax%I-- -
Co. Address: )�_ a- ZiP12L
City a& State
License Holder(print): pv�NksVI �L_ State Certification"Registration CK�ILIIV51
Notarized Signature of License Holder
- -- - - - - sworn and subscribed before me this -10 ay of 20.
Signature of Notary Public
MOO, �.WNGG4720
Cash Register Receipt Receipt Number
0 City of Atlantic Beach R7146
DESCRIPTION ACCOUNT CITY
PermitTRAK $624.10
PLRS18-02S4 Address: 1709 ATLANTIC BEACH DR APN: 169505 1390 $214.23
PLUMBING $209.00
PLUMBING BASE FEE 455-0000-322-1000 1 0 $55�00
PLUMBING FIXTURES 455-0000-322-1000 1 22 $154�00
STATESURCHARGES $5�23
STATE DBPR SURCHARGE 455-0000-208-0700 1 0 $3.14
STATE DCA SURCHARGE 455 0000 208 0600 1 0 $2.09
PLRS18-0255 Address: 1746 MARITIME OAK DR APN: 169505 1850 $192.82
PLUMBING $189.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55,00
PLUMBING FIXTURES 455-0000-322-1000 1 19 $133.00
STAFIE SURCHARGES $4.82
STATE DBPR SURCHARGE 455-0000-20&0700 1 0 $2.82
STATE DCA SURCHARGE 455-0000-208-0600 1 0 $2,00
PLRS18-0256 Address: 1644 MARITIME OAK DR APN: 169505 1935 $207.05
PLUMBING $202.00
PLUMBING BASE FEE 455-0000 322 1000 0 $55.01)
PLUMBING FIXTURES 455-0000-322-1000 1 21 $147.00
STATE SURCHARGES $5.05
STATE DEEP SURCHARGE 455-0000-209-0700 0 $303
SIATE DCA SURCHARGE
TOTAL FEES PAID BY RECEIPT: R7146 $614.10
Date Paid:Tuesday, October 23, 2018
Paid By: RINKWELL PLUMBING INC
Cashier: OB
Pay Method: CREDIT CARD 9507g
00
Printed:Tuesday,October 23,2018 11:57 AM 1 of 1 1
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS18-0254
ISSUED: 10123/2018
800 SEMINOLE ROAD EXPIRES:4/21/2019
ATLANTIC BEACH. FIL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
F N E n add.. the requirements of this permit,there may be additional restrictions applicable to this property
n to t c
OTC : I to nonal permits ""u"
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 districdts,state agencies, or federal age RcHes
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1709 ATLANTIC BEACH DR PLUMBING RESIDENTIAL $7000.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
ATLANTIC BEACH
1695051390 COUNTRY CLUB UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
RINKWELL PLUMBING INC 5105 PHILIPS HWY JACKSONVILLE FL 32217
OWNER: ADDRESS: CITY: STATE: ZIP:
TOLL FL VI LIMITED 250 GIBRALTAR RD HORSHAM PA 19044
PARTNERSHIP
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.
FEES
DESCRIPTiON ACCOUNT QUANTI]y PAIDANIMNI
PLUMBING BASE FEE 455-0000 322 1000 0 $55.m
PLUMBING PICTURES 455-0000 322-1000 22 $154.00
STATE DBPR SURCHARGE 455-0030 208 07M 0 $3.14
a $2.os
STATE OCA SURCHARGE TKE1
issued Date: 10/23/2018 TOTAL!$214.23