331 7TH ST - PLUMBING J`S�S�`Jrlu,a
CITY OF ATLANTIC BEACH
r A iiir) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
757
"-0;3 !.) INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0011
Description: 3 FIXTURES
Estimated Value: 0
Issue Date: 5/22/2017
Expiration Date: 11/18/2017
PROPERTY ADDRESS:
Address: 331 7TH ST
RE Number: 169922 0000
PROPERTY OWNER:
Name: OSWALT SUSAN M
Address: 331 7TH ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: COGBURN AND WAKEFIELD PLBG
Address: 5900 TOWNSEND BLVD APT 522 QA JOHN COGBURN
JACKSONVILLE, FL 32211
Phone:
PERMIT INFORMATION:
IPlease see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
II 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$7,500.
I
PLUMBING PERMIT APPLICATION 1----/_g,g 33)y
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 iJLRS 17- 00 1 1
JOB ADDRESS:
l5-\-ce-cf"
PERMIT#
vu
NEW OR REPLACEMENT INSTALLATION: Project Value$ TUU ,
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower J
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 __I Water Heater
Other Fixtures 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:
o Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads 0 Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
O 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
1 or not. The permit does not give autDA-kJ
ority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name re S / (Is 6 t^ 'd' ') 6" 4-1.-)Phone Number 104, L41 -03 2u
Plumbing Company cot g + (A'At4 4j R u" l" Office Phone '0'1 -3311- 33Fax `—
Co. Address: W I A
U I ti► S.-) 4 City' q-A-)/ State t Zip ?24 lo
License Holder (Print): (At." a L,, State Certification/Registration# Com_-1kit,SI41e
Notarized Signature of License Holder
��;;.;.. TONIG1NDt.ESPERGER
Before e this Jday of �. . r
2
" Q`"' MY COMMISSION#FF 924951
l ?.e EXPIRES:October 6,2019
`Q:.o?° g>ndedThruWart Pu'';,cUnderwnters Signature of Nota Public