1765 Selva Marina PLRS18-0296 PLUMBING RESIDENTIAL PERMIT PERMITNUMBER
CITY OF ATLANTIC BEACH PLRS18-0296
800 SEMINOLE ROAD ISSUED: 12/14/2018
ATLANTIC BEACH. FL 32233 EXPIRES: 6/12/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITIONr OF • • i ` BUILDING
CODE, AND CITY OF • • 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.
• ' ` • r • r • . • •
1765 SELVA MARINA DR PLUMBING RESIDENTIAL PLUMBING - 24 FIXTURES $2000.00
SUBDIVISION:TYPE OF REALESTATE ZONING: BUILDING USE
CONSTRUCTION: NUMBER: GROUP:
1720180000 SELVA MARINA UNIT05
ADDRESS:
HARRY LHAPLUMBING
INCNC 130 ARLINGTON RD S JACKSONVILLE FL 32216
• ADDRESS:
CLINE CHRISTOPHER T 1765 SELVA MARINA DR ATLANTIC BEACH FL 32233-5638
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.
DESCRIPTION ACCOUNT QUANTITY PAIDAMOUNT
PLUMBING BASE FEE 455-WW 322-1000 0 $53.00
PLUMBINGFIXTURES 455-0000322-1000 0 $000
PLUMBING FIXTURES 455-0000.322-1000 24 $16800
STATE BEER SURCHARGE 4550006208-0700 0 $3.35
STATE DCA SURCHARGE 455-0006208-0600 0 $2.23
TOTAL:$228.58
Issued Date:12/14/2018 1 oft
Plumbing Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building DepartmentGRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 (P L (Z S ( `j - C)Z9(p
Phone: (904) 247-5826 Email: Building-DeptCacoab.us PERmrrx:RES 18-035'!
JOB ADDRESS: 1765 Selva Manna Drive 32233 PROJECT VALUE$2,000-00
m MEW OR REPLACEMENT INSTALLATION and/or 132E-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 4 Septic Tank&Pit
Clothes Washer 1 Shower 1
Dishwasher 1 Shower Pan _
Drinking Fountain Slop Sink _
Floor Drain Three Compartment Sink
Floor Sink Toilet 6
Hose Bibs Urinal _
Kitchen Sink 1 Vacuum Breakers _
LaundryTray Water Connected Appliances_
Lavatory 7 Water Heater 2
Other Fixtures Water Treating System
130ISCEUANEOUS
❑Sewer Replacement
[313ack Flow Preventer
13 Lawn Sprinkler System In umber of sprinkler .ads)
OGrease Interceptor(Trap)_gallons(Requires 3 sets of plans)
❑Well"SJRWD Well Completion Form.Completed form to be submitted to the Building Deparbneat for final inspection."
❑Other
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:Cline Phone Number:
Plumbing Company: Harry L Hayes Plumbing,Inc Office Phone: (904)723-6609 Fax(904)329-4325
Co.Address: 130 Arington Road South City; Jacksonville State: Fh_. Zip: 32203
License Holder: Harry Hayes State Certification/Registration# CFC14270M
Notarked Signature of License Holder 14=_ Ld-
The foregoing instrument was acknowledged before me this—LLLday of Pttmh /201�L in the State of Florida,
County o{D\1 q0.(
.y� Signature of Notary Publ,,J(� ,— n fl 1O2�,L/
Y Nd.M:.. caMMdrM,Me
ON
UnEwy N.MooEy
My coMnuwd,oDlloaya I ersonally Known OR[ ] Produced Identification
EY I..Mitie + Type of Identification:
Updated 10/17118
Cash Register Receipt Receipt Number
10 City of Atlantic Beach R7626
DESCRIPTION ACCOUNT
PermitTRAK $228.58
PLRS18-0296 Address: 1765 SELVA MARINA DR APN: 172018 0000 $228.58
PLUMBING
$223.00
PLUMBINGBASEFEE 4550000.322-1000 0 $55.00
PLUMBING FIXTURES I 455-0000.322-1000 24 $168.00
STATE SURCHARGES $5.58
STATE DBPR SURCHARGE455-0000.208-0]00 0 $3.35
STATE DCA SURCHARGE 455-0000.208-0600 0 $2.23
TOTAL
Date Paid: Friday, December 14, 2018
Paid By: HARRY L HAYES PLUMBING INC
Cashier: BA
Pay Method: CREDIT CARD 3
Printed:Friday,December 14,2018 9:50 AM 1 of 1