1755 BEACH AVE - PLUMBING .c' r#' v` � CITY� OF ATLANTIC BEACH
S 800 SEMINOLE ROAD
�� ATLANTIC BEACH, FL 32233
--'!r It 1) INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0074
Description: 8 FIXTURES
Estimated Value: 0
Issue Date: 8/15/2017
Expiration Date: 2/11/2018
PROPERTY ADDRESS:
Address: 1755 BEACH AVE
RE Number: 169672 0000
PROPERTY OWNER:
Name: JD SWANSON LIVING TRUST
Address: 1755 BEACH AVE
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: COGBURN AND WAKEFIELD PLBG
Address: 5900 TOWNSEND BLVD APT 522 QA JOHN COGBURN
JACKSONVILLE, FL 32211
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$7,500.
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PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
. Ph(904)247-5826 Fax (904) 247-5845 PLRS 17_ 0074
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JOB ADDRESS: 11 J 3.e....A....1... A k.r{ . PERMIT#
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NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub • ti Septic Tank&Pit
Clothes Washer Shower
Dishwasher T— Shower Pan __(_
Drinking Fountain Slop Sink
Floor Drain Three Compar talent Sink •
Floor Sink Toilet _i____.
Hose Bibs Urinal
Kitchen Sink ___I_ Vacuum Breakers
Laundry Tray Water Connected Appliances —(—
Lavatory ____�__ Water Heater
Other Fixtures Water Treating System
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RE-PIPE:
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TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Sh• ower
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:
o Sewer Replacement 0 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.**
0 Other •
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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
his 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
Dr not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name SU- -S 0' ( -;2_- Phone Number
?lumbing Company 6j0b Li 444 - Ql vt- Of ice Phone 3 3` ?167 Fax
Do. Address: 6 gvi (,Afie, . LC') >
S City JA)c State � Zip 32210
:,icense Holder(Print): - b
'��L. ` S. to Certification/Regustration# �c l`(Z81�f v
Vot attcy'e of�X ideixse-.:$-:Her
•;:NY..;''••, TONT GIt:DLEuPERGER
" AdY CO!v1141SSION#t r 924951 I . l0 0.4 oL
* EXPIRES:October 6,2079 efore m s S
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"%fi d' 2andca'No Notary Public LPcerw.ts•s J / e
.ti.. -.-.-�-� - ignat,re of Notary O i e •• ♦t
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