432 Irex Rd PLRS21-0015 6 Fixtures PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
� f
t)-fA 11 CITY OF ATLANTIC BEACH PLRS21-0015
800 SEMINOLE ROAD ISSUED: 1/25/2021
7.411111,
ATLANTIC BEACH, FL 32233 EXPIRES: 7/24/2021
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:
432 IREX RD PLUMBING RESIDENTIAL PLUMBING - 6 FIXTURES $1000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171422 0000 ROYAL PALMS UNIT
02A3.00
COMPANY: ADDRESS: CITY: STATE: ZIP:
ZELLNER'S PLUMBING AND 5744 Floral Ave JACKSONVILLE FL 32211
CONST.
OWNER: ADDRESS: CITY: STATE: ZIP:
STITES STEPHEN 432 IREX ROAD OCALAATLANTIC FL 32233
BEACH
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT If\
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 6 $42.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date:1/25/2021 1 of 2
ILAIJri,' PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
ili
r� t‘ PLUMBING
OF ATLANTIC BEACH PLRS21-0015
�y v, ISSUED: 1/25/2021
800 SEMINOLE ROAD
��;3>vr ATLANTIC BEACH. FL 32233 EXPIRES: 7/24/2021
TOTAL:$101.00
Issued Date: 1/25/2021 2 of 2
PlumbingPermit A **ALL INFORMATION
Application
HIGHLIGHTED IN
A. City of Atlantic Beach Building Department G Y IS REQUIRED.
'' . 800 Seminole Rd, Atlantic Beach, FL 32233 Pi'_" a! —00
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: t5 ) r 3 SZ
JOB ADDRESS: 2- RAIL kAPROJECT VALUE $ /o u''1
❑NEW OR REPLACEMENT INSTALLATION and/or ORE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I 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 1- Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS
❑ 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.**
❑ 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. �J
Owner Name: S+-t-f S Phone Number: 366 'PDS— 9 3 19
Plumbing Company: ZC,Gl1lc./s !- /u►" 4/4) Office Phone: (9ctjVZV
Co. Address: S-N't J t 'J City: S3- State: Zip: 9 Z Z l/
License Holder: JvLr, State Certification/Registration # OFC- 27�95�
Notarized Signature of License Holder
The foregoing • strument as acknowledged efore me this .: o G,r , 20� , in the State of Florida,
Countyof `r
� V �
r
O 2
Signature of Notary P •c •.
•tib\Y D�j' TONT GINDLESPER Personally Known OR Produced Identification
353
:,. MY COMMISSION#GG 353178
..g.7 EXPIRES:,October 6,2023 Type of Identification:
:FOr F°•° Bonded Thru Notary Public Underwriters
Updated 10/17/18
/J NOTICE OF COMMENCEMENT
State of lo(7�``�' Tax Folio No. -714 Z L - 0 000
County of Du.Y6t.(.-
To Whom It May Concern:
The undersigned hereby informs you that improvements.will be made to certain real property, and in accordance with Section 713
of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: I/3a ��L'SG 2 o 0f� 4t�-`h ( ReG CLt• I {� 3x)33
OS q1 71 `a. -S �2 a 7't /� n �a�l c i (Sec �S C_OT L d
Address of property being improved: L-f)a -'-r 5 Ro A+lc. c Be&c(A ,
General description of improvements: 3„--r-o‘2,v/ r's e4.
Owner: 6ihtn S uf,Le Address: L/3 ROaGL--/A416,41icBc J-1 I 110-
Owner's
LOwner's interest in site of the improvement: re S'
Fee Simple Titleholder(if other than owner): Fee_
Name: f _
Contractor: �l
Address:
Telephone No.: { Fax No:
Surety(if any) /1 (a--
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name: G-
Address:
Phone No: Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may
be served: Name: /1 14
-
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address: •
Telephone No: Fax No:
GINDLESPERGE 3
Expiration date of Notice of Commencement(the expiration date is one (1)year f'��fiTt,�:cfateh4`PP.�1Mtdtfi4MkC3s35a 0fe nt date is
specified): ‘,Cf,
EXPIRES:Octo"ber6• ,2023
Bonded Thru`o• " •
THIS SPACE FOR RECORDER'S USE ONLY OWNER
q J
Doc#2021022168,OR BK 19556 Page 1562,
Signed:
Date: l/ S 4)
Number Pages:1
Before me this d # Ci. 7nYZ ( in the County of Duv State
1
Recorded 01/26/2021 09:53 AM, Of Florida,has personally ap ear d O . -C_Orme
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL Notary Public at Large,State lorida,Couall.f 5 val.
COUNTY My commission expires. r \ tr\,
RECORDING $10.00 Personally Known: CA___ Q or
Produced Identification: /�/