1748 W PARK TER - PLUMBING PLRS19-0067 rt %, PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
a 1 •;,;
N.
CITY OF ATLANTIC BEACH PLRS19-0067
�,v �~ 800 SEMINOLE ROAD ISSUED: 3/29/2019
- 9 EXPIRES: 9/25/2019
��'1» 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 .iddi:ional permits required from other
governmental entities such as water management districts,state agencies,or federal agencies.
I) JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1748 W PARK TER PLUMBING RESILENTIAL i pipe liner re-pipe $22750.00
I TYPE OF REAL ESTATE USE
ZONING: SUBDIVISION:
,,;CONSTRUCTION: NUMBER: GROUP:
1720200362 SELVA MARINA UNIT08
ICOMPANY: ADDRESS: ' , CITY: STATE: ZIP:
Gray's Plumbing LLC 1911 Center Dr Casselberry FL 32707
0 OWNER: ADDRESS: 1 * .1Y: I STATE: ZIP:
SHEPHERD SARAH 1748 PARK TER W ATLANTIC BEACH FL 32233
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.
c. -- 11 ,
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 1 $7.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$66.00
Issued Date:3/29/2019 1 of 2
Doc # 2019068719, OR BK 18733 Page 490, Number Pages: 1 ,
Recorded 03/28/2019 11 :50 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
Peund Number
Fofio/Parcel ID it: 1720200382
Prepared by:
Return to: Advanced Pace Technologies.LLC
70Q Aki end Street
Clermont,FL 34711
NOTICE OF COMMENCEMENT
State of Florida,County of
The undersigned hereby gives notice that Improvement will be made to certain real property,and in accordance
with Chapter 713,Florida Statutes,the following information is provided In this Notice of Commencement-
1. Description of property(legal description oldie property,and street address if available)
34-85 09-2s-29e Selva Marina Unit 8 Lo112 B1k 1:0
2.. General description of improvement
Pipe Liner
•
3. Owner information or Lessee information if the Lessee contracted for the improvement
Nrarnesareb Shepherd
Address 1748 Park Terrace West,Atlantic Beach,FL 32233
Interest in Property Homo Owner
• Name and address of fee simple titleholder(if different from Owner listed above)
Narne N/A
Address
4. Contractor
NamgChttitgpherGray Telephone Number 352-593-5140
Addresseil Center Cdve.Cassetborry,FL 32707
• 5. Surety(if applicable,a copy of the payment bond is attached)
Name N/A __Telephone Number
Address _Amount of Bond $
6. lender
Name WA Telephone Number
Mc/less
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may
be served as provided by§713.13(1)(a)7,Florida Statutes.
Narrie N/A Telephone Number
Address
8. In addition to himself or herself,Owner designates the following to receive a copy of the h onor's
Notice as provided in§713.13(1)(b),Florida Statutes.
Name NIA Telephone Number
Address
9. Expiration date of notice of commencement(the expiration date will be 1 year from the date of recording
unless a different date is specified)
WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFIER THE EXPIRATION OF THE NOTICE OF COMIAENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,FLORIDA STATUTES,AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE SOB SITE BEFORE THE RBST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT
WITH YOUR LENDER OR AN ALIO EY BEF•'• CO RICING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
SojnaturB of Owner or Lessee`o s or L. •-'s ALA::lotted OfEcer/DirectmfPattnerl/tanager Sisnatory/s Trtre/OfMce
The foregoing instrument was acknowledged before me this A5 day of y by cvirckh Ske,p1v,Y4
m name cf person
as -4-4omP. AL/rt.e.r for Adi/all CPld Puce TrChnOt4 ieS
Tope of authority,e.g..officer ruatee,attorney in fad Namo of party on behalf of whom instrument was eed
•grrAure of .RAir
• ,.E••c—State of Florida • Print, .:. 0014t1u fi11RsAtstensiBf N t ary'ubllo
, Katluska Brea
•
My Commission GG 258113
Personally Known v'/OR Produced ID 40,of Expire.os/oeao22
Type of ID Produced
Form content revised:01123114
ytf4Ly;. **ALL INFORMATION
61 ,F.,v, PlU mbing Permit Application HIGHLIGHTED IN '
r 41.;-;, '' City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd,Atlantic Beach, FL 32233 /,^
-LB 9, 12 1 —C7°O+
Phone: (904)247-5826 Email: Building-Dept@coab.US PERMIT#
JOB ADDRESS: 1-4-48 ParkTexrn re.. W, Prklnn1ic. itncl,, PROJECT VALUE$ -a-a,-ISO
L 33333
CIIEW OR REPLACEMENT INSTALLATION and/or ORE-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
Lavatory Water Heater
Other Fixtures Water Treating System
EVIISCELLANEOUS
[Newer Replacement
OBack Flow Preventer
17Lawn Sprinkler System (number of sprinkler heads) •
Elrease Interceptor(Trap) gallons(Requires 3 sets of plans)
Owen '*S/RWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.**
❑Other ° ' 2.e !_'r'1 PX
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: c)car 5 Nephi Phone Number:. 9,04/- 7E5 - 19 65
Plumbing Company: 6(Gt.y ?(U.,"► Leh LLC— . Office Phone: 37,1-3(:?=,6(5',''Fax
Co.Address: ( 4 ((�� Ce-vi-4 C✓ Di City: Co.SSd Le-te r State: /�Z. Zip: 3"2.-7o 7
License Holder: l—l/LIIS/Of/nt/ (lam( State Certification/Registration# er6/qui VC 7
Notarized Signature of License Holder ,
The foregoing instrument was acknowledged before me this a day of ill&r(h ,20 l q, in the State of Florida,
County of 1....
_.# 4
i
Signature of Notary Public '•
4000"Uj Notary Public State of Florida
X, Katiuska Brea [I Personally Known OR[ ] Produced Id-ntification
Y My Commis;ian GG 256113
��o,If
Expires 09/06/2022 Type of Identification:
Updated 10/17/18