611 SELVA LAKES CIR PLBG 3 FIX 2017 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: PLRS17-0023
Description: 3 FIXTURES
Estimated Value: 0
Issue Date: 6/6/2017
Expiration Date: 12/3/2017
PROPERTY ADDRESS:
Address: 611 SELVA LAKES CIR
RE Number: 172027 5548
PROPERTY OWNER:
Name: HARMON DEBRAN L
Address: 611 SELVA LAKES CIR
ATLANTIC BEACH, FL 32233-4378
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: CHRISTIAN BROTHERS PLUMBING
Address: 1766 ASTON HALL DR DOUGLAS POWELL JR
JACKSONVILLE, FL 32246
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 S ZZ PL
rr 11 C
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: 0 IaIC4S Ckrr � ��'�'3� PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$--ZLW ,
TYPEOFFIXTORE QTY TYPEOFFDUURE QTY
Bathtub l 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 OFFIXTORE QTY TYPEOFFIXTORE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Comportment 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:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grouse Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
**SJRWD Well Completion Farm. 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 sin months.I hereby cenify that I have reed
this application end 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,ItIhe provisions of my other state or local law regulation construction or theperformance of construction.
Property Owners Name vJ J t wrN� 'Cdnn?/ Phone Number
Plumbing Company I`S'C`I c., Qru'I ti(n f '' ('I705 _OfficePhone 551- 14) y Fax
Co.Address: �� 7 Czy�„-�-e� 'W �'� PA, Cityf 'JVrl StateF-L Zip TQ-1-"
License Holder(Print): 1'�a [�(A State Certification/Registration# 6-C IN 2A Y,y
Notar
ized License HoTefore
NIGINGIESPERGEROSA9SSION4 FF U49st Us day of2
IRES:octal... G19rna.rm',vrP��e�a^•b^ of Notary Public