999 CAMELIA ST - PLUMBING ' IA CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
Jv
ATLANTIC BEACH, FL 32233
't!O.3 1-) INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0111
Description: re-pipe 11 fixtures
Estimated Value: 2450
Issue Date: 10/4/2017
Expiration Date: 4/2/2018
PROPERTY ADDRESS:
Address: 999 CAMELIA ST
RE Number: 170994 9950
PROPERTY OWNER:
Name: RIEBER WILLIAM E
Address: 13581 OSPREY POINT DR
JACKSONVILLE, FL 32224-3020
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: D W V PLUMBING INC
Address: 4705 Cedar Point RD
JACKSONVILLE, FL 32226
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$7,500.
(1_9
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
�jq Ph(904)247-5826 Fax(904)247-5845 P(.(ZS 11- - O (( 1
JOB ADDRESS: -1 19 CONeV/L 10.. el 4 PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ a t4�0 ' af7
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
RE-PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub _(._.__ Septic Tank&Pit
Clothes Washer _____i_ Shower _
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs _ Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater [
Other Fixtures Water Treating System
MISCELLANEOUS:
n Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads n Well **
**SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
El 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 docs not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name IIPJ r 11 i ok,OA K 1 tb it c Phone Number IA 1 " Ti C I
Plumbing Company 1) W V P IV 4Y1b r /15 nc- . Office Phone?t q-7,b 76, Fax
Co. Address: t 7 5 Ct d( Pot ' / K,K . ,1 City StateFt` Zip , Z7-14.7
License Holder(Print): I,- a W• Ve r s AMII S ertificat' n/Registration# ( S 2� l i
Notarized Signature of License Holder ' i �1 A"
-....---"--"."1" —""""""""1"6°' Before me this Lt day of CL 11 ' , 20 11..
"" JENNIFER JOHNSTON
X20•.• •`.t+
?: ,�, '...1 MY COMMISSION#GG7 042984 Signature of No Public
-'`0 '"' s EXPIRES:October 27,2020 g — L.._ ellilli _
r�
'',, o Bonded Thru Notary Public Underwriters
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