411 SKATE RD - PLUMBING �� ''' � 1 CITY OF ATLANTIC BEACH
tg4;s> 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
&CM S) INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0095
Description: 8 FIXTURES
Estimated Value: 0
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 411 SKATE RD
RE Number: 171529 0000
PROPERTY OWNER:
Name: MIKE PHILLIPS
Address: 992 OCEAN BLVD
ATLANTIC BEACH, FL 32233
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.
4 * 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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 •
Ph(904)247-5826 Fax(904) 247-5845 PL RS 1-7 -0095
JOB ADDRESS: I r t) f C a `C--e- PERMIT#
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•
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NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY 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 j Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory aL Water Heater
Other Fixtures j S .ohie,( Water Treating System
a. -1-01 le.
RE-PIPE: .
TYPE OF FIXTURE QTY 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
MISCELLANEOUS: • .
o Sewer Replacement ❑ Back Flow Preventer o Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads o Well ** • •
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
o Other
=,., ,!m_..r_:.,.,,.;_'1_ .1-:?::t:-.4. in H?$_s3*?',71re wit:'.7'i a?A5�' .fi i.-,?Em?3. ":'r v.�.:�k'3*• 2 1'L.i r_:_ _. ..' ..r,'.l'
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 authofl/ti
rityyto violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name V. Pk. t(k p S Phone Number
?lumbing Company � /" (vw! br9 Co ,445 Office Phone I0y- 3/ a62-O5r
moo. Address: S3 ltD 471-10,K GQc,;P city t1(ldd[e bVY j State aL Zip 3;06
license Holder(Print): ut0 11. >°T(/‘ )cL rvf'' S .t�Certification/Registration# CFc (4 z'31C
Notarized Signature of License Holder / ,, ' ' ar ' /
p TONI GINDLESPERGERLik _ 1
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