1067 Hibiscus St plbg permit r3 `�J CITY OF ATLANTIC BEACH
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: PLRS17-0149
Description: re-pipe 12 fixtures
Estimated Value: 0
Issue Date: 11/20/2017
Expiration Date: 5/19/2018
PROPERTY ADDRESS:
Address: 1067 HIBISCUS ST
RE Number: 171088 0106
PROPERTY OWNER:
Name: WALKER MARIE R
Address: 1067 HIBISCUS ST
ATLANTIC BEACH, FL 32233-2651
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: JERRY NOLAN PLUMBING INC
Address: 3115 HAMPSTED DR QA JERRY JAMES NOLAN
JACKSONVILLE, FL 32225
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$7,500.
I�
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, PL 32233
P--h(904)247-5826 fax (904) 247-5845
JOB ADDRESS: �� /TI 6 S <� S S` - PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF F/XTURE Q7'Y
Bathtub Septic Tank&Pit
j 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 Appl iances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
BathtubSeptic Tank&Pit
Clothes Washer �- Shower
-
Dishwasher �- Shower Pan
Drinking Fountain Slop Sink
Floor Drain Thee Compartment Sink
Floor Sink Toilet
Hose Bibs — Urinal
Kitchen Sink �- Vacuum Breakers
LaundryTrayWater Connected Appliances
Lavatory _ Z Water Heater —�—
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement o Back Flow Preventer o Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads El Well
** VentRKJD Well Completion Form. Completed form to be submitted to the Building Departmfor final inspection."
❑ Other r C4O
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 1 have read
this application and know the same to be true and correct. All provisions of latus and ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to viol_at/e�the provisions of any other state or local lav regulation construction or the performance of construction.
Property Owners Name '� ��-C ,)4 (�",- Phone Number Gad -1696
Plumbing Company inn 1:7 7l(`'4f d`� t Z7 1 c Office Phone �6-V tZ;-1 Fax—Lt(-t(-k�qd
Co. Address: f o a °� 3 S�0 6 S// City. -A a-ksulV1 State FLZip 3J.;?.l-►-
License Holder(Print): J"'r 1, �U�Y` State Certification/Registration# CFCOS 7k ye
f
Notarized Si future of License Holder
iativ?y JENNIFERJOHNSTON Before me this a day of / V�� 20��r
MY COMMISSION#GG 042984
;; :;; EXPIRES:October 27,2020
-17 Foy F��°-' Bonded Thru Notary Public Underwriters Signature of Notary Public