133 BEACH AVE - PLUMBING .�� •a : ` � CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
;i �% INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0071
Description: GARAGE -8 FIXTURES
Estimated Value: 0
Issue Date: 8/8/2017
Expiration Date: 2/4/2018
PROPERTY ADDRESS:
Address: 133 BEACH AVE
RE Number: 170213 0000
PROPERTY OWNER:
Name: SCROGINS WILLIAM C
Address: 2000 CHEROKEE DR
NEPTUNE BEACH, FL 32266
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: J WHITEHEAD PLUMBING INC
Address: 12811 BEAUBIEN RD JASON WHITEHEAD
JACKSONVILLE, FL 32258
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845 PARS i7 —007 (
JOB ADDRESS: l TActl /4 ' 1 '1 — 1i!,f:,' ' 5 PERMIT#
NEW OI • PLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub • Septic Tank&Pit
Clothes Washer Shower •
Dishwasher t Shower Pan 7
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink '
Floor Sink Toilet 2.
Hose Bibs Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray 2 Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE QTY 00 TYPE OF FIXTURE 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 ...;,:r
MISCELLANEOUS:
o Sewer Replacement 0 Back Flow Preventer 0 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.**
O 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 that 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
or not. The permit does not give autho 'ty to violate the provisio i s of any other state or local law regulation construction or the performance of construction.
Property Owners Name i, ' • "../i_II., Phone Number
•
Plumbing Company PEWis)V-) i vfiA (O' '* Office Phone"3 (4 Fax
SI�
Co. Address: ] D t " '` ! Cit77 State rt- Zip3`L c
License Holder (Print): VithSEIAir? IsState Certification/Registration#GE&l iAj
Notarized Signature o Lice • . .lder '.
TONI GINDLESPERGER !_
?.4,: ".,.: MY COMMISSION#FF 924951 Before me this day o i) c + 2OU
Iy;.._rif ,: EXPIRES:October 6,2019
:4., ��; Bonded TMuNotary Put*Uoden ters , ignature of Notary Public e
4