2039 Vela Norte Cir PLRS19-0236 Water Heater E_;: PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACHPLRS19-0236
ISSUED: 12/26/2019
800 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 EXPIRES: 6/23/2020
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:
2039 VELA NORTE CIR PLUMBING RESIDENTIAL WATER HEATER $400.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169506 1100 SELVA NORTE UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
CONCEPT RENAISSANCE
SERVICES LLC 3903 Edidin DR JACKSONVILLE FL 32277
OWNER: ADDRESS: CITY: STATE: ZIP:
TEVEPAUGH BILLY L 2039 VELA NORTE CIR ATLANTIC BEACH FL 32233-4533
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.
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 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: 12/26/2019 1 of 2
rj'`'' PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
t `� PLRS19-0236
CITY OF ATLANTIC BEACH
.Ny �� 800 SEMINOLE ROAD ISSUED: 12/26/2019
°i=19Y ATLANTIC BEACH. FL 32233 EXPIRES: 6/23/2020
Issued Date: 12/26/2019 2 of 2
FLRS1C YOz3 �
Plumb •i(; Permit Application HIGHLIGHTED
**ALL INFORMATION
HIGHLIGHTED IN
City of AI zintic Beach Building Department GRAY IS REOUIRED.
800 Sem -:Dle Rd, Atlantic Beach, FL 32233
Phone: ( 04) 247-5826 Email: Building-Dept@coab.us rCKIviIT:r:
JOB ADDRESS: 2039 VELA a:_RTE CIR, ATLANTIC BEACH, FL 32233 PROJECT VALUE $400.00
j"JEW OR REPLACEMENT NSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub _ Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Founts 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 1
Other Fixtures Water Treating System
DVIISCELLANEQUS
❑Sewer Replacemeni
❑Back Flow Prevente
❑Lawn Sprinkler Sysi ri (number of sprinkler heads)
Elrease Interceptor rap) gallons (Requires 3 sets of plans)
Well **SJRWD Well C •oletion Form.Completed form to be submitted to the Building Department for final inspection **
DOther
mommimmeiiiimmem
Permit becomes void if work : oes not commence within a six month period or work is suspended or abandoned for six months.
I hereby certify that I have re :1 this application and know the same to be true and correct. All provisions of laws and ordinances
governing this work will be c, reolied with whether specified or not. The permit does not give authority to violate the provisions
of any other state or local la‘, regulation construction or the performance of construction.
Owner Name:BILLY TEVEF .,I.JGH Phone Number: (904)241-9571
Plumbing Company: CONC RENAISSANCE SERVICES, LLC Office Phone: (904)805-5858 Fax
Co. Address: 3903 EDIDIN I: :; _ City: JACI4SONVILLE State: FL Zip: 32277
License Holder: RICARDO ._ANELA i Sty a Certification/Registtation# CFC 1429637
Notarized Signature of Lic -ise Holder ( T i �- r
The foregoin instrument as acknowledged before me th3 day of -hp C. , 20 /9 in the State of Florida,
County of IAA/ '
,a� �tE Signature of Notary Public /
yQ• J G -�— ---
�ce6e A Tynan
My ;aemmss:on 3G".!.<;,;3C
''. e E, ,,as 34'02,2023 [U ersonally Known ORE ) Produced Identification
Type of Identification: ejte nQ,n
Updated 10/17/18
,0-. Cash Register Receipt Receipt Number
alCity of Atlantic Beach R11368
DESCRIPTION 1 ACCOUNT 1 QTY I PAID
PermitTRAK $66.00
PLRS19-0236 Address: 2039 VELA NORTE CIR APN: 169506 1100 $66.00
PLUMBING $62.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 1 $7.00
STATE SURCHARGES $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: R11368 $66.00
Date Paid: Thursday, December 26, 2019
Paid By: CONCEPT RENAISSANCE SERVICES LLC
Cashier: CT
Pay Method: CREDIT CARD 4
Printed:Thursday, December 26,2019 2:01 PM 1 of 1 1
MATO