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1651 Maritime Oak Dr PLRS19-0051 water treatment permit PERMIT NUMBER PLUMBING RESIDENTIAL PERMIT 7- CITY OF ATLANTIC BEACH PLRS19-0051 800 SEMINOLE ROAD ISSUED: 3/12/2019 ATLANTIC BEACH. FIL 32233 EXPIRES: 9/8/2019 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. LNOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property ' TIC 0 t t t hat may be found in the public records of this county, and there may be additional permits required from other t m g gov m overnmental entities such as water management districts, state agencies, or federal agencies. JOB ADDRESS: PERMITTYPE: DESCRIPTION: VALUE OF WORK: 16S1 MARITIME OAK DR PLUMBING RESIDENTIAL install water treatment $1803.68 system TYPE OF REALESTATE BUILDING USE I ZONING: SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: ATLANTIC BEACH 1695052000 COUNTRY CLUB UNIT 02 COMPANY: ADDRESS: CITY: STATE: ZIP: AFFORDABLE 3760 KORI RD JACKSONVILLE FL 32257 WATER/KINDER INC OWNER: ADDRESS: CITY: STATE: ZIP: Jack Anderson/Candi 1651 Maritime Oak Dr ATLANTIC BEACH FL 32233-5531 Mishko 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 k Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT PLUMBING BASE FEE 455-0000-322-1000 0 $55.00 PLUMBING FIXTURES 4S5-0000-322-1000 1 $7.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 Issued Date: 3/12/2019 1 of 2 PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER Jr) CITY OF ATLANTIC BEACH PLRS19-0051 ISSUED: 3/12/2019 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 EXPIRES: 9/8/2019 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$66.00 Issued Date:3/12/2019 2 of 2 PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, Fl, 32233 Ph (904) 247-5826 Fax (904) 247-5845 I # —Cos JOB ADDRESS: I PERMIT NEW OR REPLACEMENT INSTALLATION: Project Value$ 1 Z Q 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 Toilet Floor Sink Urinal Hose Bibs Vacuum Breakers Kitchen Sink Water Connected Appliances Laundry Tray Water Heater Lavatory Water Treating System Other Fixtures RE-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 Water Heater Lavatory Water Treating System Other Fixtures MISCELLANEOUS: • Sewer Replacement 0 Back Flow Preventer E Grease Interceptor (Trap) gallons(Requires 3 sets of plans) • Lawn Sprinkler System-Number of Heads [3 Well ** SJRWD Well Completion Form. Completei_form_i6_ be submitted to the—Building Department for final inspection." o Other ea 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 r d this application and know the same to be true and correct. All provisions of laws and ordinances governing this work wil I 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. Property Owners Name i. —Phone Numbe -U _nRl? cro r Office Phone F go Plumbing Company. 14 P-.r->A A LO 0 18 f 1�fZ Q-71 ax Co. Address: Zrl(PO. KOR-i ROaa--J city JA-c,kaot16 i I t e- State—FL Zip 022-59 D E12, .fi License Holder(Print): M'-AIZK 19 - 9)�J —Statece iication/Registration#_000613(0 Notarized Signature of License Holder day of 20n- Sworn and subscribed be me this Nowy Pub1c Stge of FbrWa Dorothy M.Devore Signature of Notary P licl mycomflftsionGG061383 Ex*"02M=21 Cash Register Receipt Receipt Number =I�20�. City of Atlantic Beach R8395 DESCRIPTION ACCOUNT CITY PAID PermitTRAK $66.00 PLRS19-0051 Address: 1651 MARITIME OAK DR APN: 169505 2000 $66.00 PLUMBING $62.00 PLUMBING BASE FEE 455-0000-322-1000 $55.00 PLUMBING FIXTURES 455-0000-322-1000 1 $7.00 STATESURCHARGES $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: R8395 $66.00__ Date Paid:Tuesday, March 12, 2019 Paid By: AFFORDABLE WATER/KINDER INC Cashier: CT Pay Method: CREDIT CARD 09592C Printed:Tuesday,March 12,2019 11:17 AM 1 of 1 to