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CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
_ ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUSr CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0051
Description: GARAGE -2 FIXTURES
Estimated Value: 0
Issue Date: 7/11/2017
Expiration Date: 1/7/2018
PROPERTY ADDRESS:
Address: 340 OCEAN BV
RE Number: 170177 0010
PROPERTY OWNER:
Name: FOSTER GARY WAYNE
Address: 110 LEMON ST
NEPTUNE BEACH, FL 32266
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: OGRE PLUMBING CONTRACTORS INC
Address: 5340 Otter LN
MIDDLEBURG, FL 32068
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 P L (LS (7_0D S (
SOBADDRESS: 340 Oceat) ^ PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TFPEOFFmmRE QTY TIDE oFFLYTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slap Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urmal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
LavatoryWater Heater
Other Fixtures �— Water Treating System
RE-PI'E:
TYPE OFFLYTORE QTY4 TYPE OFFIRTUItE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pau
Drinkmg Foumamf 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 ❑ Back Flow Preventer ❑ Grease Interceptor(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
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 the 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
ornot. The permit does not give authorityto violate the provisions of my other state or local law regulation construction orthe performance of construction.
Property Owners NameQ: ` —Cks l P Phone Number
Plumbing Company l7aV'a 11 ;11 �ilvlq COct acIm'S Office Phone 3fa �loZ Fax
Co. Address: 53t(6 D -Zr IJ�aGtC eit� M,)d(gLpT_state G� zip 3��p(re8
License Holder(Print): L In VI Z ra-e V' t State Certification/Registration
Notarized Signature ojLicemeHolder K
TOM GIN SKRGEa
fore me this day o J 20,_ _
'e MYOOMMISSIM#FF92495t
EXPIflESOatober6,2019 5 tuieofNotazyPublic
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