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253 ROYAL PALMS DR # 1 PLRS19-0066 PLUMB 39 FIX PERM PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER PLRS19-0066 CITY OF ATLANTIC BEACH ISSUED: 3/28/2019 800 SEMINOLE ROAD EXPIRES: 9/24/2019 ATLANTIC BEACH. FL 32233 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + 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: 253 ROYAL PALMS DR 1 PLUMBING RESIDENTIAL PLUMBING - 39 FIXTURES $85000.00 TYPE OF ZONING: :D • • • GROUP: 177602 0060 SECTION LAND COMPANY: ADDRESS: KDS VENTURES LLC 4341 N RED TIP RD JACKSONVILLE FL 32218 • ADDRESS: 0 U R PROPERTIES INC PO BOX 330108 ATLANTIC BEACH FL 32233-0108 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 • • i 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 39 $273.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $4.92 STATE DCA SURCHARGE 455-0000-208-0600 0 $3.28 TOTAL: $336.20 Issued Date:3/28/2019 1 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 Co~v 19- c0e)c)5- �``'"`'" Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: JOB ADDRESS: &10 ROJECT VALUE $R5 000 25 ❑NEW OR REPLACEMENT INSTALLATION and/or El RE-PIPE P `S[9 _0066 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 T Floor Sink Toilet C Hose Bibs Urinal -2- Kitchen Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater 2— Other Other Fixtures 7te44-. D',*1-4 Nater Treating System ❑MISCELLANEOUS ❑ Sewer Replacement c� ❑ Back Flow Preventer � 5 1-1Lawn 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. ** ❑ 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: 041)?// I-'rdlo&-LJ _-- C' Phone Number: Plumbing Company: /� ©S' 12ed 7C114-r LL,G Office Phone:9*I- &,3y2,3 Fax Co. Addressl�?/�y/,/ Cir �� ,r�� City: y/0yrro' State:/ Zip: 32,0 License Holder: State Certification/Registration #O fel i�ZT6 Notarized Signature of License Holder The foregoing instrument was acknowledged before me this:; day of "- t1,1 C_1,`\ , 20 i i , in the State of Florida, Countyof l Signature of Notary Public, 0 t ty ,; JOSETTE A RETHMEL .._. Commission#FF 218261 Personal) Known OR Produced Identification r,•, ,a Expires April 7,2019 � ) Y I a' I . Q`4.0 S.WTn,TroyFain Y,wme W"te 7M9 Type of Identification: -4q- D1y'��'S I�tCJ2�lti Updated 10/17/18