1798 Atlantic Beach Dr plbg permit CITY OF ATLANTIC BEACH
si 800 SEMINOLE ROAD
' ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0085
Description: 29 FIXTURES
Estimated Value: 0
Issue Date: 8/25/2017
Expiration Date: 2/21/2018
PROPERTY ADDRESS:
Address: 1798 ATLANTIC BEACH DR
RE Number. 169505 1620
PROPERTY OWNER:
Name: JEFFREY S BERICHON FAMILY TRUST
Address: 1798 ATLANTIC BEACH DR
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: NELSON PLUMBING CO. INC.
Address: 11624 -1 DAV E DAVIS CREEK RD OA SCOTT GARY NELSON
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 d b SC=,Ph(904)247-5826 Fax (904)247-5845 ID L RS l7 -
JoB ADDREss: I 1 1 A ATI Arad-L % -PC k b t _PERMIT# RES I )-60S
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OFFDauRE QTY TYPEOFFOauRE 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
E)vLavatory Water Heater
Other Fodraes /� ater Treating System
RE-PIPE:
TYPEOFFtxTuRE QTY TYPE OF FlxwRE 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:
❑ 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 silt month period or work is suspended or abandoned for six moms.I hereby certify that I have read
this application and know the sane to be true and onnect. All provisions of laws end ordinances governing this work will be complied with whether specified
or not. The pemdt does not give authority to violate the provisions of my other state or local law regulation conshuction or the performance of construction.
�.i
Property Owners Name a s DE t7oao S Phone Number
Plumbing Company Ahaa5 aoy Ploe i m, �n TNG, Office Ph e 7 67__YBBy Fax
Co. Address: - Vi = City 1 V State-Zip _�,22_56
License Holder(Print): o o S 'fication/Registration# 02-0 379
Notari d Aa or
MVCAawsSlONafFssz Sworn and sub cribed before me this day of 20_
` ' E%PINES'.Novembaf la.20
la
Signature of Notary Public