1619 Atlantic Beach Dr plbg permit (2) .�3 `�� CITY OF ATLANTIC BEACH
r `> 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: PLRS17-0117
Description: WATER TREATING SYSTEM
Estimated Value: 0
Issue Date: 10/13/2017
Expiration Date: 4/11/2018
PROPERTY ADDRESS:
Address: 1619 ATLANTIC BEACH DR
RE Number: 169505 1075
PROPERTY OWNER:
Name: EBERT CYNTHIA M
Address: 2303 FIDDLERS LN
ATLANTIC BEACH, FL 32233-4681
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: AFFORDABLE WATER/KINDER INC
Address: 3760 KORI RD SPECIALTY WATER (CONS TDS QB)
JACKSONVILLE, FL 32257
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 PLRSI 7 0� ( 7
JOB ADDRESS: 1� I R 4TLQN r1 c 130404 DRQ')t' )qr0tiaC PERWr#
32-233
NEW OR REPLACEMENT INSTALLATION: Project Value$ &&.00
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 Z
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
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other
Pergrit 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 correct. 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.
f3 i L L h C�.T Phone Number N H �
Property Owners Name _ 9D
Plumbing Company. A Ff-0 9 0 A B LE VJA I ER Office Phoneo2�
Co. Address: 3 r7 1<0121 R oa�_r1 City JAc-k5orlU i l le State EL- Zip 32 Z 5 I
License Holder(Print): A R Yi R • t�1 N t State Ce ification/Registration# 000 18(V
Notarized Signature of License Holder
Sworn and subscribed be me this day of OC E013 g7 20 1?
��+^ No to M. smote of FbriQa
. o«any M.oeuvre Signature of Notary P lic
My C"w*ssron GG 061383
pr Expires 02/09/2021