1750 Atlantic Beach Dr plbg permit e s� CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
'!Cost �'' INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0118
Description: 25 FIXTURES
Estimated Value: 0
Issue Date: 10/16/2017
Expiration Date: 4/14/2018
PROPERTY ADDRESS:
Address: 1750 ATLANTIC BEACH DR
RE Number: 169505 1660
PROPERTY OWNER:
Name: TOLL FL VI LIMITED PARTNERSHIP
Address: 250 GIBRALTAR RD
HORSHAM, PA 19044
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: DARLEYS PLUMBING INC.
Address: 4472 PHILLIPS HWY QA CARL LESLIE DARLEY
JACKSONVILLE, FL 32207
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 P L RS (7—o tCS
JOB ADDRESS: Sy ���- �3f�+�N 0►+ 4 PERMrr#
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 3 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 l Vacuum Breakers
Laundry Tray �_ Water Connected Appliances 2
Lavatory Water Heater i q/
Other Fixtures _�_ t e� Water Treating System 1
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:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
** SIRWD 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 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 connect. All provisions of laws and ordinances governing this work will be complied with whether specified
or 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 -Tow /R�*S Phone Number .
Plumbing Company A e�--i S Office Phone`1 o y '7'1'7 1"'fFax �W
Co. Address: _ y4�� pt'1Lt-7PS rFw.l City Jac spa. ✓_- State ro Zip 3Zz°
License Holder(Print): Gw' State Certification/Registration# CFC oS6'�02
Notarized Signature of License Holder
Sworn and subscribed befor a this 14#rj��day of VCTO d:-�- 20/7
JOANNE Mf"L
WUry Public -SIAM a AwWo Signature of Notary Public
COmM ISSW+/6Q 021781
My Comm.ExpkM Myo 29,2020
.'-Bonded t" Notary Assn.