725 ATLANTIC BLVD #9 - PLUMBING (2) (.----
;. rl
` � CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
V ATLANTIC BEACH, FL 32233
-,0;3 9%' INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0165
Description: 9 FIXTURES
Estimated Value: 0
Issue Date: 12/14/2017
Expiration Date: 6/12/2018
PROPERTY ADDRESS:
Address: 725 ATLANTIC BLVD UNIT 9
RE Number: 171363 0000
PROPERTY OWNER:
Name: ATLANTIC-PENMAN LLC
Address: 500 S 3RD ST
JACKSONVILLE BEACH, FL 32250
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: STYLES SMITH PLUMBING, INC
Address: 1537 PENMAN RD SUITE A QA DARRELL GLEN SMITH
JACKSONVILLE BEACH, FL 32250
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU 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.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 fax(904)247-5845 P LRS ('7- O/65
JOB ADDRESS: 7� S A f"/c,✓I 7, c. /3 I Vj (//i ) 1 PERMIT# (04/i�17 -G2!,
�
NEW OR REPLACEMENT INSTALLATION: Project Value O/ 766 • 60
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher _ Shower Pan
Drinking Fountain Slop Sink
Floor Drain a Three Compartment Sink 1
Floor Sink 3 Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures han a S,nK 3 Water Treating System
RE-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:
[-I Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
0 Lawn Sprinkler System-Number of Heads Ll Well **
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other 2s? — IO(a,fr%, - 8c.r 7 ex oel, .J q k, - G��
-G , ,
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. MI provisions of laws and ordinances governing this work will be complied with whether specified
or not. 'the permit does not give a ionty to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name ci--tt/�'ci. L OD I C. Phone Number
Plumbing Company Sly/6S S,v„`*i? 21,/,-lb,'9 I/-office Phoneg6k -.2111-1113) Fax
Co. Address: /537 /ee'?/.7,v7 r'. City i"X i3ee c In State R k•Zip 3ra015O
License Holder(Print): .9yI e S w .5-1, fi State Certification/Registration#CFG 1 t{aS3G 1,2-
Notarized
Notarized Signature of License Holder ..X;r- '7------ ,
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-- v= "" 1x Before me this 13 day 2Torn GINDLL:PERS: 11
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j' ,_ MY CM-, SICK,'FF9 151
EK Es.oo :',Err �.��1g y Signature of Notary Public
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