469 ATLANTIC BLVD #6 - PLUMBING CITY OF ATLANTIC BEACH
.5 800 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: PLBG17-0006
Description: 3 compartment sink
Estimated Value: 0
Issue Date: 12/6/2017
Expiration Date: 6/4/2018
PROPERTY ADDRESS:
Address: 469 ATLANTIC BLVD 06
RE Number: 170690 0000
PROPERTY OWNER:
Name: DIAMOND REAL ESTATE PROPERTIES IV LLC
Address: 6517 LOU DR S
JACKSONVILLE, FL 32216
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: JOHN MOON PLUMBING
Address: 1103 PALM CIR QA JOHN ROBERT MOON JR
JACKSONVILLE BEACH, FL 32250
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$7,500.
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PLUM dNG PERMIT APPLICATION
CITY OF ATLANTIC ci EAC;
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 fax (904) 247-5845 �(�
--1-7--0000
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JOB ADDRESS: "/ 3wd 1 L' PERMIT#
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NEW OR REPLACEMENT INSTALLATION: Project Value$ 242577,401)
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 I
Floor Sink Toilet
Hose Bibs Urinal
IIKitchen Sink ri= Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory i � Water Heater •
Other Fixtures f / Water Treating System
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RE-PIPE:
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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:
0 Sewer Replacement 0 Back Flow Preventer o Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
o Lawn Sprinkler System-Number of Heads L7 Well **
**SIR WD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
o Other .
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Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.1 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 nor. 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 D 1 °y 0 £C-x1 L c---(7--n-re-Pito-11047
p n i11 -i Phone Number �/°�WI-0-06 d
Plumbing Company A) 1 zany 7 6 Office Phone Z i_7' •Fax
Co. Address: 7-607 l'.t't -)`b zr City cggei State L- Zip 30-z-33
License Holder(Print): Ilk i . ,;LL O ' #1.ri/.. State Certification/Registration# CF.-LS/Wel)
1Prk Notarized Signature of License Holder ( _
Req 0 li
-= day of
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C11 ti Y�7: TONI GINDLESPEPGER . Before me ihl -
*: MY COMMISSION r rF 924951 i _
f' � ..liz"..', EXPIRES:October E,2019. Signature of Notary Public
I 1 P Bonded 7hru Notary Public Underwrter