357 SHERRY DR - PLUMBING . 0. ��r4,
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CITY OF ATLANTIC BEACH
r A . 800 SEMINOLE ROAD
~ ATLANTIC BEACH, FL 32233
r A �,� INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0013
Description:
Estimated Value: 0
Issue Date: /- 0/(, 7
Expiration Date:
PROPERTY ADDRESS:
Address: 357 SHERRY DR
RE Number: 169825 0175
PROPERTY OWNER:
Name: POPPELL RICHARD R
Address: 357 SHERRY DR
ATLANTIC BEACH, FL 32233-5349
1 GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: MIKE SANVILLE PLUMBING INC
Address: 530 ELLIS RD STE 212 QA MICHAEL RAYMOND SANVILLE,II
JACKSONVILLE, FL 32254
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 P L I� 1,7` 0 0 (.3
Ph(904)247-5826 Fax (904) 247-5845
S17—0 u �
JOB ADDRESS: 3c 7 Ski 0
PEiuv>QT# a
•
NEW OR REPLACEMENT INSTALLATION: Project Value$
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
•
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 o 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
or not. The permit does not give authority to violate the
ei„., ,, f?rovisions of any other state or local law regulation construction or the performance of construction.
Property Owners Namee /1 Phone Number
an ,'Th/'CP1h Office Phone 3n-O2e-(/ Fax• TS8 7- 9>
Plumbing Company [AAP_/ $j ,'uui /(c
� � tate Zip.7257*
Co. Address: 5-ki �//i fat .� �10� C ty k S of p
License Holder(Print): Mrda€( .5-1)/1// '/( /ate Certific tion/Registration#CrCG57 'C/U
Notarized Signature of License Holder
"""" .. 20 1 1
-_1%:sk TONI GINDLESPERGER Before me this i2 day •
2s, .r, '_
• MY COMMISSION#FF 924951
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Signature of Notary Public �� -r
Bcnded Thru Noay Public Underwriters —
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