290 Pine St plumbing permit 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-S814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0052
Description: 3 FIXTURES
Estimated Value: 0
Issue Date: 7/11/2017
Expiration Date: 117/2018
PROPERTY ADDRESS:
Address: 290 PINE ST
RENumber: 1705500000
PROPERTYOWNER:
Name: FLEMING MARY ELLEN
Address: 290 PINE ST
ATLANTIC BEACH, FL 32233-4014
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: WAYNE CONN PLUMBING INC.
Address: 6915 W BEAVER ST
JACKSONVILLE, FIL 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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Favc (904)247-5845
JaRADDREss:. zz)zz,/� PERMT
NEW OR REPLACEAMNT INSTALLATION: Project Value$
TFrEoFFWvAE QTY TYPEoFFamRE QY7
Bathtub S
S=o Tank&Pit
Clothes Washer
Dishwasher
Drinlcing Fountain Shower Pan
FloorDrant Slop Sink
Floor Sink — Three Comparhment Sink
Hose Bibs — Toilet
Kitchen Sink — Urinal
Laundry Tray — VacuumBreakers;
Lavatory — Water CramectedAppliances
Water Header
Oth Water Treating System
RE-PIPE:
17lTE OFF=URE QTy TYPEOFFMVRE Qly
Baffitub Septic Tank&Pit
Clothes Waster Shower
Dishwasher Shower P
Drinking Fountain Slop Sink an
FloorDrain
Floor Sink Three Compartment Sink
Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Cormected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
• Sewer Replacement []Back Flow Preventer 0 Grease Interceptor(Frap) gallons(Requires 3 sets of plans)
• Lawn Spritilder System-Number of Heads Li Well
**SJRWD Well Completion Form. Completed form to be submitted to the BuilYngDepartment for final inspection."
o Other
P.m,itb.om.s void if work does.otoommersetwithin a Siam"th pmod or work is suspended or abandoned for six months.I hereby cartify that Ihave mad
this application and know the same to be true and correct. All provisions of laws and ordirmacos goveming this work will be complied with wheactspecified
ornot. The permit does not give au��or#Y to violate the provisions of my other state or local law regulation construction orthe performance of construction.
Property Owners Name A,12 Phone Number
Plumbing Company
ce Phone ax:
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Co.Address:A� 1-�5- *5edc-�' y/cnA cit� . 4,1 —SttA/-Zip
License Holder(Print): vlelqA4�A2 -�V44 ,05 State Certification/Registration#4���
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fore me this day of
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EXPIRES 0.kb�16,2019
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