1792 Atlantic Beach Dr plbg permit �S�l
+ 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: PLRS17-0055
Description: 21 FIXTURES
Estimated Value: 0
Issue Date: 7/14/2017
Expiration Date: 1/10/2018
PROPERTY ADDRESS:
Address: 1792 ATLANTIC BEACH OR
RE Number: 169505 1625
PROPERTYOWNER:
Name: TOLL FL VI LIMITED PARTNERSHIP
Address: 250 GIBRALTAR RD
HORSHAM, PA 19044
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: DARLEYS PLUMBING INC.
Address: 4472 PHILLIPS HWY OA CARL LESLIE DARLEY
JACKSONVILLE, FL 32207
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 [::�L P-S ( 7 _0 o S S
JOB ADDRESS: / 791 Aid -rrc /?05*-fr d` PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Values
TYPEOFFIXTE/RE QTY TYPE OFFLxTuRE QTY
Bathtub L Septic Tank&Pit -
Clothes Washer 1 Shower i
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Side
Floor Sink Toilet —T—
Hose Bibs —� Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray r Water Connected Appliances Z
Lavatory T Water Heater I
Other Fixtures � Water Treating System 1
RE-PIPE:
TYPE OF FIXTURE QTY TYPEOFFLYTuRE 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:
❑ Sewer Replacement O Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of pians)
❑ Lawn Sprinkler System-Number of Heads ❑ Well *"
**SJRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.**
❑ Other _
Perrnit becomes void if work does not commence within a six month period or work is suspended or abandoned for sin months.I hereby certify that I have read
this application and know the same to be true and correct Aa provisions of haws and ordinances governing this work will be complied with whether specified
or not The permit does not give authority to violate the provisions of my other state or local law regulation construction or the performance of construction.
PropertyOwnersName n %oo�a ff5 Phone Number
PltmmbingCompany ✓AR.FwJ A -OX-c. .Lc- Office Phone 727�f8Y F�7z7-AtW-
Co.Address: Y17z iwy—TAl: ttwy - City 74+- Statef`(-Zip ?rusr'7
License Holder(Print): CtA, State Certification/Registration# Cfc osa'roa
Notarized Signature of License Holder
JOANNE MEHI Before me this day of 20�
Notary Public.State of f ofMa
tommifaba*an 02 V at Signature of Notary Public
MY 00-M Expires Aa9 29,2020
brded1ft'h9A NNkrrN NHNY Assn.