1602 MARITIME OAK DR - PLUMBING I �
„,„
s.
iit CITY OF ATLANTIC BEACH
g1? 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
1-'40119 INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0136
Description: install 19 plumbing fixtures
Estimated Value: 0
Issue Date: 10/27/2017
Expiration Date: 4/25/2018
PROPERTY ADDRESS:
Address: 1602 MARITIME OAK DR
RE Number: 169505 1970
PROPERTY OWNER:
Name: RIVERSIDE HOMES OF NORTH FLORIDA INC
Address: 12276 SAN JOSE BLVD
JACKSONVILLE, FL 32223
GENERAL CONTRACTOR INFORMATION:
Name: NELSON PLUMBING CO. INC.
Address: 11624 -1 DAV E DAVIS CREEK RD QA SCOTT GARY NELSON
JACKSONVILLE, FL32256
Phone: 9042624884
Name: RIVERSIDE HOMES OF N FL
Address: 414 OLD HARD RD STE 502 MATTHEW ROBERTS
ORANGE PARK, FL 32003
Phone: 9042624884
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$7,500.
PLUMBING PERMIT APPLICATION C>1 \
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845 e-S(1- — a (3(
JOB ADDRESS: I (o02 M At i t itYlE (94-jc, () PERMIT# 2,=- (--, - oes$
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank& Pit
Clothes Washer _I__ Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs 3 Urinal
Kitchen Sink __I_ Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Li 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:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ 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 11 l VCIt. \QC ft.owtq Phone Number
Plumbing Company / )t c osaf A vwt A,LU6 Co Tea Office Phone 242-t{a S y Fax
Co. Address: ((b Z — I onvr kit i S tr C State t'Z Zip 322-s-6
Mri
License Holder(Print): a-o ..y Mt. a t../ ii, / . e Certification/Registration# 0203
Notarized Signature of License Holder /
O'°Y'* "ASS Sworn and subscnbed before me thi. day 4y--- 20
_= i•, ;_. MY COMMISSION k FF 900342
.' ,L EXPIRES.November 16,2019
j1;° Bonded Thru Notary Public Underwriters Signature of Notary Public Orr ZQ.t b�„,..