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1 Ocean Blvd PLRS19-0011 plbg permit PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER rPLRS19-0011 CITY OF ATLANTIC BEACH V 800 SEMINOLE ROAD ISSUED: 1/15/2019 ATLANTIC BEACH, FL 32233 EXPIRES: 7/14/2019 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' BUILDING CODE, ' OF BEACH CODEOF ORDINANCES . ALL CONDITIONS OF . • PLEASE CAREFULLY.READ 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: --VALU-E OF WORK: 1 OCEAN BLVD PLUMBING RESIDENTIAL PLUMBING - 8 FIXTURES $6361.00 TYPE OF • • GROUP: 170229 0000 ATLANTIC BEACH COMPANY: ADDRESS: LANCE MAXWELL 8604 OLD ORANGE PARK RD TALLAHASSEE FL 32303 PLUMBING, INC. • ADDRESS: ASHFORD ATLANTIC C/O EASLEY MCCALEB & ASSOCIATES MAITLAND FL 32751 BEACH LLP 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 PAID AMOUNT PLUMBING BASE FEE 455-0000-322-1000 0 $55.00 PLUMBING FIXTURES 455-0000-322-1000 0 $0.00 PLUMBING FIXTURES 455-0000-322-1000 8 $56.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 Issued Date: 1/15/2019 1 of 2 PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER PLRS19-0011 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 1/15/2019 1 ATLANTIC BEACH, FL 32233 EXPIRES: 7/14/2019 TOTAL: $115.00 Issued Date: 1/15/2019 2 of 2 s j,. Plumbing Permit Application **ALL INFORMATION City of Atlantic Beach BuildingDepartment HIGHLIGHTED IN p GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: ouildin>~-Uept(«�coab us PERMIT# : JOB ADDRESS: PROJECT VALUE $ 37-7-3,3 r'J � �S ( �L�( � VEIN OR REPLACEMENT INSTALLATION and/or ORE-PIPE TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower _1 Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Z Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory _ Water Heater Other Fixtures Water Treating System ❑MISCELLANEOUS ❑Sewer Replacement ❑Back Flow Preventer ClLawn Sprinkler System (number of sprinkler heads) 03rease Interceptor(Trap) gallons (Requires 3 sets of plans) ❑Well **SJRWD Well Completion Form. completed form to be submitted to the Building Department 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: i'�/04—kl Phone Number: `1,o Plumbing Company- �/�,/l� > 1�A� u ,1j jy,��ffice Phone�'') FaXYL�� Co. Address: v2k,3 (�jf� � c/7!2 City: StateA zip:n,2r2r-)fo,-a— License Holder: g n C e M cA X VI/ e i� I State Certifi atj n/Registration # Notarized Signature of License Holder �J The foregoing instrument was acknowledged before me this O day of �� , 20Zen the State of Florida, County of ? LAUREN D.BRIGHT EL ignature of Notary Public 1.(Y COMMISSION$GG 207785'aEXPIRES:June t7,2022 Vie; �o„�ar„„L „Y�er�u�aer B [ Personally Known OR [ ] Pro ced Identification Type of Identification: Updated 10/17/18 rS Cash Register Receipt Receipt Number rl_ City • : R7845 '��J,iJ�r DESCRIPTION ACCOUNTQTY PAID PermitTRAK $115.00 PLRS19-0011 Address: 1 OCEAN BLVD APN: 170229 0000 $115.00 PLUMBING $111.00 PLUMBING BASE FEE 455-0000-322-1000 0 $55.00 PLUMBING FIXTURES 455-0000-322-1000 8 $56.00 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 :411 CITY OF ATLANTIC BEACH 800 SENINOLE RD ATLANTIC B:AC,FL 32233 01'15 2019 11:54:31 CREDIT CARD VISI,SALE Card-- XXXXXXXX)0(XX2540 SEQ u; 3 Batch;: 771 INVOICE 3 Approval Code: 039077 Entry Method: Marlual Mode: Online Tax Amount: $0.00 Card Code: M SALE AMOUNT $1151 CUSTOMER COPY Date Paid:Tuesday,January 15, 2019 Paid By: LANCE MAXWELL PLUMBING, INC. Cashier: BA Pay Method: CREDIT CARD 3 Printed:Tuesday,January 15,2019 11:58 AM 1 of 1 Ir nwar