535 Atlantic Blvd plbg permit Ali
is CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING COMMERCIAL OR MULTIFAMILY SEPARATE PLANS -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLBG17-0005
Description: GATE STATION -47 FIXTURES
Estimated Value: 0
Issue Date: 10/18/2017
Expiration Date: 4/16/2018
PROPERTY ADDRESS:
Address: 535 ATLANTIC BLVD
RE Number: 170684 0000
PROPERTY OWNER:
Name: GATE PETROLEUM COMPANY
Address: 9540 SAN JOSE BLVD
JACKSONVILLE, FL 32257
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: MCKENDREE PLBG & HTG (PLBG
Address: 4248 LENOX AVE QA CLIFFORD FOSTER MCKENDREE
JACKSONVILLE, FL 32205
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.
CITY OF ATLANTIC B ACH
800 SEMINOLE RDCash Register •
ATLANTIC BEAC,FL 32233
City of Atlantic 10 18 2017 16;01:51 Beach 9
CREDIT CARD
VISA SALE PAID
ARD u XXXXXXXXXXXX31�+6
INVOICE 0011 $393.60
'EQ 7; 0008
Hatch#; 000659 ress: 535 ATLANTIC BLVD APN: 170684 0000 $393.60
Approval Code; 01955G $384.00
'_ntry Method; MarWl BASE FEE 455-0000-322-1000 0 $55.00
Itde' Onlrx FIXTURES 455-0000-322-1000 47 $329.00
Tax Amount: $0.00 s $9.60
i.ard Code; M
R SURCHARGE 455-0000-208-0600 0 $5.76
3AIE AMOUNT $393 W SURCHARGE 45500002080700 0 $3.84
• 1 • $393.601
CUSTOMER COPY
Date Paid: Wednesday, October 18, 2017
Paid By: MCKENDREE PLBG & HTG (PLBG
Cashier: ME
Pay Method: CREDIT CARD 8
i�
Printed:Wednesday,October 18,2017 4:02 PM 1 of 1 �
,wwr
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 1D L QG 17-- 0 0 d,5
.TOB ADDRESS: 535 A+i an+i C Sl yd. PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value s
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain I I Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink _jVacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
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 t= Back Flow Preventer C 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 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 comLct. 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 l y p�G. Pe+r c 1 to 1k..m Phone Number 0104—,. I
Plumbing Company mcC )PJ�C�re e tS P��nbi r1g Office Phone ,��'t 3M ��P
' Faxq�+
Co. Address: 4rA4G LenOX Ave. flue— Cit J a x State P:L- Zip 8:Q0
License Holder(Print): l i- Ord F. t'C tate rtificati egistration#C-MO � ��
Notarized Signature of License Holder
3.. PAMELA t�tlP s scribed befor a this S y of c+c bee 20-a
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