1618 ATLANTC BEACH DR - PLUMBING CITY OF ATLANTIC BEACH
sem.
vit � 800 SEMINOLE ROAD
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: PLRS17-0116
Description: install 23 fixtures
Estimated Value: 8000
Issue Date: 10/11/2017
Expiration Date: 4/9/2018
PROPERTY ADDRESS:
Address: 1618 ATLANTIC BEACH DR
RE Number: 169505 1125
PROPERTY OWNER:
Name: RIVERSIDE HOMES OF NORTH FLORIDA INC
Address: 1227 SAN JOSE BLVD STE 120
JACKSONVILLE, FL 32223
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: RIVERSIDE HOMES OF N FL
Address: 414 OLD HARD RD STE 502 MATTHEW ROBERTS
ORANGE PARK, FL 32003
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.
Cc!..3)
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845 p QS n-- o((Jo
JOB ADDRESS: ( g Art-r4+'.ITt-�Pkc(-t D YL PERMIT# 2E51-7 006
NEW OR REPLACEMENT INSTALLATION: Project Value $ 1449 o
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 3 Septic Tank&Pit
Clothes Washer ) Shower 2
Dishwasher 1 Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet y
Hose Bibs 2. Urinal
Kitchen Sink �__ Vacuum Breakers
Laundry Tray Water Connected Appliances I'
Lavatory Water Heater 2.
Other Fixtures Water Treating System 4
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 **
** SJRWD 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 2(VE7t S i v2€ fT e tufts Phone Number
Plumbing Company N cS o,•J Y Lu r+'I iS;ntg ( .LwL Office Phone 2-62.'1 88 y Fax
Co. Address: 114 2 Lf—I 0A Vk CC444, Q.D L Ci State A_ Zip 3223-6
r
License Holder(Print): Seo <! MELS•- , S y< / ication/Registration# 02.0.0 3 7
,, ..if
No ! • older 4 . 4/I
s,v''y''• LISA P.BASS
= MY COMMISSION F 900342 Sworn and subscribed before me this day of J1\9-e 20 17
'a•.���;a EXPIRES:November 16 2f)19
Rt,0 Bonded ThruWary Public Urbenurtrsn Signature of Notary Public /i�.(J O �j