1302 Main St plbg permit ri�Ly�l�'
s s f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
yr
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: PLRS17-0133
Description: 11 FIXTURES
Estimated Value: 0
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 1302 MAIN ST
RE Number: 171052 0040
PROPERTY OWNER:
Name: EVANS CHARLES P
Address: 6475 COUNTY ROAD 315 C
KEYSTONE HEIGHTS, FL 32656-7753
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach FL 32233
Ph(904)247-5826 fax(904) 247-5845 P LRS ( 7— �j�
JOB ADDRESS: PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE
Bathtub Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan _
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
i Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum 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 1 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 Z Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
I.-I Sewer Replacement o Back Flow Preventer o Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads r i Well **
**.VJRWD Well Complelion Form. Completed form to be submitted to the Building Department for final inspection.**
n 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 certilj'that 1 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 la%v regulation construction or the performance of construction.
Property Owners Name rk 'tp`u-7 Phone Number
Plumbing Company ��"^ /U' 4't -'''r 1 f 2"` Office Phone g ��� Fax
Co. Address: P 6 d-1-� 3 s Z`7`/ City Y z «r State �L Zip ?1 zS
License Holder(Print): 1''' 7 c7 IV-' /'t— State Certification/Registration# S__7 9Z
Notarized Signature of License Holder —7
TON{GINDLESPERuE�
SPOR } Before me this ��2 day 2U__1__� _—
'
MY COt.1LiiSSICN{"rr 24951
EXPIRES:October 6,2015 Signature of Notary Public t��
e±'y'o�' S^r.??d Thro hoary
lers
Pub!I'Underwr