1612 Atlantic Beach PLRS18-0288 Receipt Number
Cash Register Receipt
City of Atlantic Beach R7460
DESCRIPTION
PermitTRAK $214.23
PLRS18-0288 Address: 1612 ATLANTIC BEACH DR APN: 169505 1130 $214.23
PLUMBING $209.00
PLUMBING BASE FEE 1 455-0000 322-1000 1 0 $55,00
PLUMBING FI�URES 455-0000-322-1000 1 22 $154.00
STATE SURCHARGES $5.23
STATE BEER SURCHARGE 455-0000-208-0700 1 0 $114
STATE DCA SURCHARGE 455-0000-208-0600 1 0
TOTAL FEES PAID BY RECEIPT: R7460 $214.23
Date Paid:Tuesday, November 27, 2018
Paid By:ATLANTIC BEACH PARTNERS LLC
Cashier:CB
Pay Method: CREDIT CARD 6720g
Printed:Tuesday,November 27,2018 2:44 I'M 101
"ALL INFORMATION
Plumbing Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 1
Phone: (904) 247-5826 Email: Building-DeptOcclab.us PERMIT#:
JOB ADDRESS: 4ElP,&08m.Be.&Orwe-L.t PROJECT VALUE$.R000 00
ONEW OR REPLACEMENT INSTALLATION and/or DRE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE CITY
Bathtub 3 Septic Tank&Pit
Clothes Washer 1 Shower I
Dishwasher 1 Shower Pan
Drinking Fountain — Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 4
Hose Bibs 2 Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray 1 Water Connected Appliances
Lavatory 6 Water Heater I
Other Fixtures WaterTreating System I
CIMISCELLANEOUS
[:]Sewer Replacement
[ZlBack Flow Preventer
01-awn Sprinkler System (number of sprinkler heads)
arease Interceptor(Trap)_gallons(Requires 3 sets of plans)
n Well**SjRWO Well Completion Form.Completed form to be submitted to the Building Department for final Inspection.
0Other
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 be true and correct. All provisions of laws and ordinances
governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions
of any other state or local law regulation construction or the performance ofconstruction.
Owner Name:Toll Brothers JEENNEOLl—Phone Number: (904)
Plumbing Company Rinkwell Plumbtng lc� Office Phone: (904)732�5554 Fax(904)732-5477
Co.Address: 6055 Chester Avenue City:W&Ix,ovitle St a t e: zip:
License Holder: Severly Rink State Ce rt ifi ca tio n/Registration#
Notarized Signature of License Holder
The foregDA'ng unstrunnelit was acknowledged before me this2:nday of 0�3, 20jeln the State of Florida,
County of D,—%N
Signature of Notary Public
I Praduced Identification
MELI��RSUEL
_0 Personally Known OR
'Type of Identification:
��J.2 Vn
I'm_ H�13
updoWdIO117118
PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS18-0288
ISSUED:
800 SEMINOLE ROAD EXPIRES:
ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PIM 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.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
Ica
rthat may be found in the public records of this county,and there may be additional permits required from other
e
governmental entities such as water management districts,state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1612 ATLANTIC BEACH DR PLUMBING RESIDENTIAL $8000.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP: -
ATLANTIC BEACH
1695051130 COUNTRY CLUB UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
RINKWELL PLUMBING INC 5105 PHILIPS HWY JACKSONVILLE FL 32217
OWNER: ADDRESS: CITY: STATE: ZIP:
ATLANTIC BEACH 414 OLD HARD RD FLEMING ISLAND FL 32003
PARTNERS LLC
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 an City right-of-way.
FEES
DESCRIPTION
$55,00
PLUMBING BASE FEE 4S5 DOOR 322 IWO 0
PLUMBING FIXTURES 455 0000�322 1000 22 $154.00
STATE DBPR SURCHARGE 455-0"208-07M 0 $3,14
STATE OCA SURCHARGE 455 0000-208 0600 0 $2.09
TOTAL:$214.23
issued Date: 1 of 2