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630 Begonia St PLRS20-0044 12 Fixtures �, ie. PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH PLRS20-0044 v 800 SEMINOLE ROAD ISSUED: 2/28/2020 ATLANTIC BEACH. FL 32233 EXPIRES: 8/26/2020 1 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: 630 BEGONIA ST PLUMBING RESIDENTIAL PLUMBING - 12 FIXTURES $6000.00 TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170921 0000 ATLANTIC BEACH SEC H COMPANY: ADDRESS: CITY: STATE: ZIP: DREW HARTMANN 4331 CEDAR RD ORANGE PARK FL 32065 PLUMBING, INC. OWNER: ADDRESS: CITY: STATE: ZIP: HOLSTAR LLC 6685 BOWIE RD JACKSONVILLE FL 32219 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 416 ur 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 12 $84.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.09 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$143.09 Issued Date:2/28/2020 1 of 2 PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER 1 (----y-m-7-.4„),r. ill' PLRS20-0044 iiii CITY OF ATLANTIC BEACH 15 IF ~, 800 SEMINOLE ROAD ISSUED: 2/28/2020 R 9a EXPIRES: 8/26/2020 ATLANTIC BEACH. FL 32233 Issued Date:2/28/2020 2 of 2 PlumbingPermit Application **ALL INFORMATION €..t!,,,,‘,„,, �� HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED.y „ �800 Seminole Rd, Atlantic Beach, FL 32233 [D L Rc,.Z �._c'`-Lt 1-- v,o._ Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: O JOB ADDRESS: o'3 (Y /�(.'�0�I (5. 7/-- PROJECT VALUE $ ; •> 000 0'- ❑NEW OR REPLACEMENT INSTALLATION and/or ❑RE-PIPE TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub / Septic Tank& Pit Clothes Washer Shower / Dishwasher ___1_ Shower Pan -- Drinking Fountain Slop Sink Floor Drain — Three Compartment Sink -- Floor Sink Toilet Z. Hose Bibs Z Urinal Kitchen Sink I Vacuum Breakers Laundry Tray Water Connected Appliances ----- Lavatory .2— Water Heater _/ Other Fixtures Water Treating System ❑MISCELLANEOUS <1) ) LJ 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.** CI Other /1/(141 ca,/s71--/f 07 c- / 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: i.4 0 t S{G {1 L L Et Phone Number: Plumbing Company:219M3 /74";47Z4/7/AA4v1 Office Phone: irii-- 1620 Fax 2b2 1 )./ 1 Co. Add ress:0,/CCC7,4 7L- k c City:©K”, P7-01--State: —Zip: ?20 License Holder: ,2ecei 1 (K 14 ty 1Tl'�'v'Sfate Certification/Registration # C- /W C-67,„; Notarized Signature of License Holder // CJ �^ c-,) The foregoirf trument as acknowledged before me this?ay of r e. r-� , 202 ;?n the State of Florida, County of T U f c, �trm TONIGINDLESPERGEP, ig ture of Notary Pu Ca .A___ ' .: ! ';„.::/ _; MY COMMISSION#GG 353178 •'• EXPIRES:October6,2023[ ] ersonally Known OR [ ] Produ d Identification •,.....F.... Bonded Thn Notary Pubic U . �\ ____1;_i!. of Identification: i Updated 10/17/18