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2400 Seminole Rd PLRS19-0222 Trim Only E--.- ,-.2-\lit7;„ PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER 4 . CITY OF ATLANTIC BEACH PLRS19-0222 r� " ISSUED: 12/4/2019 �� 800 SEMINOLE ROAD �Ji3"/ ATLANTIC BEACH. FL 32233 EXPIRES: 6/1/2020 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: 2400 SEMINOLE RD PLUMBING RESIDENTIAL PLUMBING TRIM ONLY 40 $0.00 FIXTURES TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 168354 0000 SECTION LAND COMPANY: ADDRESS: CITY: STATE: ZIP: TOUCHTON PLUMBING 416 N RYAN AVE JACKSONVILLE FL 32254 OWNER: ADDRESS: CITY: STATE: ZIP: PETER SLEIMAN 10739 DEERWOODOPARK BLVD STE JACKSONVILLE FL 32556 30 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 20 $140.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.93 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $199.93 Issued Date: 12/4/2019 1 of 2 J� iL''r PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER r PLRS19-0222 ,, ,, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 12/4/2019 `''; >r ATLANTIC BEACH. FL 32233 EXPIRES: 6/1/2020 Issued Date: 12/4/2019 2 of 2 Plumbing Permit Application **ALL INFORMATION HIGHLIGHTED IN 1 City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 / n S I —Q Z Z Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: JOB ADDRESS: 2400 Seminole Road Atlantic Beach PROJECT VALUE$ ['NEW 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 ❑MISCELLANEOUS U�e T G.-IC i ►n 5 ? l V,tib; ng Ov e{ ❑Sewer Replacement q�J ['Back Flow Preventer �� rn h )y 6--o1p G -c DLawn Sprinkler System (number of sprinkler heads) 0 rQ( TU D3rease 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: e L= r- Phone Number: Plumbing Company: Touchton Plumbing Contractors Inc Office Phone: (904)389-9299 Fax Co. Address: 416 Ryan Ave City: Jacksonville State: FL Zip: 32254 License Holder: Eric Touchton State Certification/Registration # CFC056489 r' Notarized Signature of License Holder rd The foregoin-g instrument was acknowledged before me this 0 day of Dec , 201`? , in the State of Florida, County of .1)(....), moo- (e&ZrSHERRY HAYES * 57�}* Commission#GG157714 Signature of Notary Public 3� `t—•'C... '�. ` 4.:10,7 Expires March 3,2022 FOFi,.° ©oodedThruBudget Notary Seryi NI Personally Known OR [ ) Produced Identification Type of Identification: Updated 10/17/18 PLRSt -cI3� oC; 2",trv, fie. • ) r&a /At ()07cid J;iptia ceed,e_ y�%,-�.�/�- �/�L✓SI�6'- oJ �r� � , ?ciaci m /1-vele i2a/ DEC6)4- 01- CAtsoiw-DA-- /1:44-11\ t 3 pis c* _' Cash Register Receipt Receipt Number City of Atlantic Beach R11190 DESCRIPTION ACCOUNT I QTY PAID PermitTRAK $199.93 PLRS19-0222 Address: 2400 SEMINOLE RD APN: 168354 0000 $199.93 PLUMBING $195.00 PLUMBING BASE FEE 455-0000-322-1000 0 $55.00 PLUMBING FIXTURES 455-0000-322-1000 20 $140.00 STATE SURCHARGES $4.93 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.93 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL FEES PAID BY RECEIPT: R11190 $199.93 Date Paid: Wednesday, December 04, 2019 Paid By: TOUCHTON PLUMBING Cashier: CT Pay Method: CREDIT CARD 05667G Printed:Wednesday, December 04, 2019 9:46 AM 1 of 1 li