1158 OCEAN BLVD - PLUMBING 4, " : �� % CITY OF ATLANTIC BEACH
.� + - `.' sn ",?)1 800 SEMINOLE ROAD
,v, • �~ ATLANTIC BEACH, FL 32233
I-011 c..) INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0094
Description: 9 FIXTURES
Estimated Value: 0
Issue Date: 8/31/2017
Expiration Date: 2/27/2018
PROPERTY ADDRESS:
Address: 1158 OCEAN BLVD
RE Number: 170287 0000
PROPERTY OWNER:
Name: SHAD KERRY A ET AL
Address: 202 FALKNER DR
CHAPEL HILL, NC 27517
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: COUF PLUMBING LARRY COUF
Address: 1104 Wood Hill PL
JACKSONVILLE, FL 32256
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$7,500.
1
I
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
. Ph(904)247-5826 Fax(904) 247-5845 PL Rs i7— o O l 4
JoB AADDRESS: /1 '. •c-eAv, /3 . j PERMIT#
•
NEW OR REPLACEMENT INSTALLATION: Project Value$ 6'00
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower .g
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink •
Floor Sink Toilet 2
Hose Bibs
Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 9. Water Heater i
Other Fixtures - Water Treating System
RE-PIPE:
TYPE OFFIXTURE
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 0 Well ** `
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
o Other
^�:_.: ;.;__'s�. - _:..c..'-�:-:z `s.:3s r'�: "^.•4..;., .ay. :J •• '.'.-`:..Y'.;::. ...� v ':t.-q. ,..-. .a, �, _ v2v�3�2iL?.,:Y,.1.•—,_-_.i'..t.�r�. .:�.
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 Ke(-c--kiS h4cA Phone Number
?lumbing Company Ce, f 171 vrnh,:, Office Phone
Fax
:,1o. Address: (le ct oa41n,°C( 1? City"' Jew_ State FL Zip 38c:9
._ieense Holder(Print): v,/-1G�ff State Certification/Registration# CfCl°t2`9I K7
Votar ized Signature of License Holder -- /'"
, •.F` a,,,, TONT GINDLES :efore me t' / dal
+_ MY COMMISSION#FF 924951 � 20
=.-,. ;4: EXPIRES:October 6,2919 .ignature of Notary PublicDk..../(:)-
;f /= hu``, 6cnded Thru hkr:ary Public UnderHrite.s