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705 Atlantic Blvd. PLRS19-0056 plbg permit „w,r' ,�. PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER ill . Y °' PLRS19-0056 i .4 . CITY OF ATLANTIC BEACH ii.b.,Tair 800 SEMINOLE ROAD ISSUED: 41'0 EXPIRES: ATLANTIC BEACH. FL 32233 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: 705 ATLANTIC BLVD PLUMBING RESIDENTIAL 13 PLUMBING FIXTURES $6100.00 SOUTHERN ROOTS TYPE OF REAL ESTATE I BUILDING USE ZONING: SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170655 0000 SALTAIR SEC 01 COMPANY: ADDRESS: CITY: STATE: I ZIP: STYLES SMITH PLUMBING 1537 PENMAN RD SUITE A JACKSONVILLE FL 32250 BEACH OWNER: ADDRESS: CITY: STATE: . ZIP: SEMINOLE SOUTH, LLC 2300 MARSH POINT RD, 301 NEPTUNE BEACH FL 32266 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. FEES 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 13 $91.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.19 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 Issued Date: 1 of 2 Sm PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER (0-41.1:4 ;-, 4 CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ISSUED: l \`f ATLANTIC BEACH. FL 32233 EXPIRES: TOTAL: $150.19 Issued Date: 2 of 2 ,ILA,,/,- Plumbing Permit Application **ALL IN HIED I Or"; Js rt \ HIGHLIGHTED IN ' City of Atlantic Beach Building Department GRAY IS REQUIRED. f Mi 800 Seminole Rd, Atlantic Beach, FL 32233 PLR S i9 -c s x c,..,- Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: COMM )1 — 1000 2 JOB ADDRESS: X70 L i717c r, C )/v d PROJECT VALUE $# 6,//067 . 00 ❑NEW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank& Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink I Floor Drain Three Compartment Sink I Floor Sink I Toilet d•-• Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory of. Water Heater 1 Other Fixtures 3 Water Treating System ❑MISCELLANEOUS ❑ Sewer Replacement ,'?.._--) ❑ Back Flow Preventer ❑ Lawn Sprinkler System (number of sprinkler heads) ❑ Grease 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. ** rl Other fend IL 13✓, Id a of Seviii ifs !UCtS. 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: Phone Number: — Plumbing Company: ..7ty/&.9 SM(,�^ ) /ow-'Pi J Office Phone: 0211 — q/3 I Fax — Co. Address: 153.7 )2,,,,.,,,,.„, rd City: L1- X i3et:Nt;// State: FL.Zip: 3).25-0 License Holder: Slyie 5 ts-ir'h--) State Certification/Registration # C-FL- )42.iS(.:9`62_ Notarized Signature of License Holder ,TA' The foregoin instrument yeas acknowledged before me this I e of I V j-c4L, 201 1 in the State of Florida, County of w c -. TONIGINDLESPERGER Signature of Notary Publi 44 . I 'A,•°, MY COMMISSION#FF 924951 ..... 4i5: +- = '• "deo ' ` EXPIRES:October 6,2019 ersonally Known OR [ ] Produced Identificati•© .,2,,-."->....'i, rr�'"' Public Underwriters ""�Q' Bonded°` Type of Identification: Updated 10/17/18