2347 FIDDLERS LN - PLUMBING (.._.,1,2.V.Pf 6
_ CITY OF ATLANTIC BEACH
d\\,,,
;-- 0 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
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"�e;i 9INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0167
Description: install 25 fixtures
Estimated Value: 0
Issue Date: 12/20/2017
Expiration Date: 6/18/2018
PROPERTY ADDRESS:
Address: 2347 FIDDLERS LN
RE Number: 169463 0112
PROPERTY OWNER:
Name: HAMMOND JULIE A TRUST
Address: CIO JULIE A HAMMOND TRUSTEE5823 PIN OAK COMMONS CT
BURKE, VA 22015-2841
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: DARLEYS PLUMBING INC.
Address: 4472 PHILLIPS HWY QA CARL LESLIE DARLEY
JACKSONVILLE, FL 32207
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$7,500.
aS
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 P L a_ S t-- -0 1
JOB ADDRESS: 2 3`r? Fz100G t s 1-4-4'i- PERMIT#
NEW OR REPLACEMENT IINSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank&Pit
Clothes Washer r Shower 3
Dishwasher t Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet '-1
Hose Bibs 'I Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater I
Other Fixtures Water'Treating System l
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 authoritynto violate the provisions of any other state or local law regulation construction or the performance cif construction.
Property Owners Name t� C"y r /1..,,.../e..1 Phone Number
Plumbing Company �J14tO--1S 74- 3s/4G <. Office Phone 7o'( 1 iN$Y Fax ?c'l Ti? f'fie
Co. Address: _ yW11- Pttii.LTyf r{w.f City JPtic soa.raJ State Fc Zip 722''7
License Holder(Print): Gt2C.. L °Aga- State ertification/Registration# CX 0 C6ro z
Notarized Signature of License Holder
I JOANNE MEHL ` Sworn and subscribed beton/me thi Z day of Oi.ck.. zr.- 20 /7
( : .� dt= Notary Publicmmission x.StateGG of Florida021751 '
( s �"• Signature of Notary Public 1.4,v11°
II ?�°�
.c My Comm.Expires Aug 29.2020
Bonded in, r:Ir Ni' , votary Assn / _.