152 SANDY BEACH LN - PLUMBING r
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4s CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
tipATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0141
Description: 10 FIXTURES
Estimated Value: 0
Issue Date: 11/3/2017
Expiration Date: 5/2/2018
PROPERTY ADDRESS:
Address: 152 SANDY BEACH LN
RE Number: 173414 0195
PROPERTY OWNER:
Name: BEACHES HABITAT FOR HUMANITY INC
Address: 797 MAYPORT RD
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: ADVANTAGE PLUMBING
Address: 880 MAYPORT RD QA GREG GAUSE
JACKSONVILLE BEACH, FL 32240
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845 ��L4 S 1 _ o 4 l
JOB ADDRESS: ISS 4jo.v.6....\ PERMIT# Rc..) VI - O l�
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer f Shower i
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 2
Hose Bibs �— Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray TT Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE QTY IP 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 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
O Lawn Sprinkler System-Number of Heads 0 Well **
** SIRWD 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 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.
Property Owners Name ppCS a.+Ob) \ \\c ?Gk Phone Number 9) 3544 - /AO/
Plumbing CompanyGcn� �a able,NkVWneez\ �'\v.,,,\'. Office Phone ct)o141-q4 4% Fax q)al`O -9T59I
Co. Address: ISO 1Y1 arc qck \ City Oat:Inkic.:.j st&N State Vt. Zip 30 35
License Holder(Print): cu:\ S State Certification/Registration#
Notarized Signature of License Holder SO/p1 t>elae-10
Before me this 5""` day of K6d Q,h 10t j- 20 11
.y+ Notary Public State of Flonoa G/ _
Amy J Sloan Signature of Notary Public
My Commission GG 143268
°y. ' Expires 09/14/2021