168 SEMINOLE PLBG ALT 2017 00 "'9'
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0042
Description: Washer Relocate
Estimated value: 0
Issue Date: 6/30/2017
Expiration Date: 12/27/2017
PROPERTY ADDRESS:
Address: 168 SEMINOLE RD
RE Number: 170595 0000
PROPERTY OWNER:
Name: HALVORSEN JOSEF D
Address: 168 SEMINOLE RD
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: STEEG PLUMBING
Address: 1601 MAIN ST OA JAMES STEEG
ATLANTIC BEACH, FL 32233
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845
n PERMIT#
JOB ADDRESS: )
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oF FIXTURE QTY TMOFFMTURE QTY
Bathtub Septic Tank&Pit =
Clothes Washer Z Shower
Dishwasher Shower Pan Slop Sink —
Drinking Fountain —
Floor Drain Three compartment Sink Toilet —
Floor Sink
Urinal —
Hose Bibs Vacuum Breakers
Kitchen Sink Water connected Appliances
Laundry Tray Water Heater —
Lavatory Water Treating System —
Other Fixtures
RE-PIPE:
TYPEOFFIXTURE QTY TYPE oFFIXTURE QTY
Bathtub Septic Tank&Pit Shower —
Clothes Washer
Shower Pan
Dishwasher —
Drinking Fountain Slop Sink
Floor Dram Th —
Three Compartment Sink Toilet —
Fluor SinkUrinal
—
Hose Bibs Vacuum Breakers —
Kitchen Sink Vacuum
Laundry Tray Water Connected Appliances
Lavatory Water Heater —✓
Other Fixtures Water Treating System
MISCELLANEOUS: F
❑ Sewer Replacement Li Back Flow Preventer ❑ Grease Iuterce for(Trap)_gallons(Requires 3 sets of plans)+*
❑ Lawn Sprinkler System-Number of Heads ❑ Well
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other
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Periodapplicationbs voi it work same to continence be true and comet. sAll provisions of laws and ordinances ess govere7d or ning this woork will be complied with whether sp cif�d
this
h noc The nait does not give authority f e violate the provisions of any other state or local law regulation construction or the performance of construction.
Phone Number
Property Owners Name /yIl I/ Rin
P/ O �/�c Office Phone Fax
Plumbing Company r-3
Co.Address: >,
City" l�L�L�__State P�Zip
License Holder(Print): State Certification/Registration#rte
Notarized Signature of License Holder rusorval `�
Before rp 's��day of 20�----
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uvcr,n. lavrccouvee S[gnature of�Notary Public
spr EXPIREa:Orober11,2010
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