1645 Selva Marina Dr PLRS18-0295 plbg permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
PLRS18-0295
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 12/13/2018
ATLANTIC BEACH. FL 32233 EXPIRES: 6/11/2019
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.
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1645 SELVA MARINA DR PLUMBING RESIDENTIAL replace sewer, 2 toilets, & $1500.00
lavatory
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1719940000 SELVA MARINA UNIT 05
COMPANY: ADDRESS: CITY: STATE: ZIP:
BILL FENWICK PLUMBING 11623 E COLUMBIA PARK DR JACKSONVILLE FL 32258
OWNER: ADDRESS: CITY: STATE: ZIP:
FORDPHILLIPS PROPERTIES 1835 THIRD ST N JACKSONVILLE FL 32250
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. I
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
FEES 4diAM4
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 4 $28.001
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $87.00
Issued Date: 12/13/2018 1 of 2
PERMIT NUMBER
PLUMBING RESIDENTIAL PERMIT
PLRS18-0295
CITY OF ATLANTIC BEACH ISSUED: 12/13/2018
-01219, 800 SEMINOLE ROAD EXPIRES: 6/11/2019
ATLANTIC BEACH. FL 32233
Issued Date: 12/13/2018 2 of 2
Plumbing Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Btjilding-Dept@coab.us PERMIT#: ()L
JOB ADDRESS: 1645 Selva Marina Drive PROJECT VALUE 5 1,500.00
OINEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
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
EDMISCELLANEOUS
Esewer Replacement
013ack Flow Preventer
01-awn Sprinkler System (number of sprinkler heads)
Ehrease Interceptor (Trap) _ gallons (Requires 3 sets of plans)
F-1 Well --SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.
E10ther Reroughing two toilets and a lavatory
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 of construction.
Owner Name:Campbell Ford Phone Number: Li 09_L9 0 -0'3_ez,
Plumbing Company: Bill Fenwick Plumbing 0 f f i c e P h o n e: -1)2-1 F a)C-�OH-_-1-2-'-VW 3.,,c7
Co. Address: 11623 Columbia Park Dr E City: Jacksonville State: FL Zip: 32258
License Holder: Bill Fenwick 10 State Certification/Registration # CFC040039
Notarized Signature of License Holder 0UjA-1-tV'(Ck J/-r.
The foregoing instrument was acknowledged before�/e this d of Dacep-,\bcv; 20
in the State of Florida,
County of V_-)k )\./ Cj
(iA 2N
BRIANNA TALLMAN Signature of Notary Public
Commi5sion 0 G.G 40B36
My Commission F--xpires
Nov*mber 114, 2020 IV(Personally Known OR Produced Identification
Type of Identification:
Updated 10/17118
Cash Register Receipt Receipt Number
v
L City of Atlantic Beach R7621
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $87.00
PLRS18-0295 Address: 1645 SELVA MARINA DR APN: 171994 0000 $87.00
PLUMBING S83.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 4 $28.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R7621 $87.00
Date Paid: Thursday, December 13, 2018
Paid By: FORDPHILLIPS PROPERTIES LLC
Cashier: CB
Pay Method: CREDIT CARD 51425
Printed:Thursday, December 13,2018 4:29 PIM 1 of 1