379 SKATE RD-5 FIXTURES CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j 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: PLRS18-0040
Description: install 5 fixtures
Estimated Value: 4500
Issue Date: 2/15/2018
Expiration Date: 8/14/2018
PROPERTY ADDRESS:
Address: 379 SKATE RD
RE Number: 171671 0000
PROPERTY OWNER:
Name: Ty Bliss
Address: 379 Skate Road
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: STYLES SMITH PLUMBING, INC
Address: 1537 PENMAN RD SUITE A
JACKSONVILLE BEACH, FL 32250
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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* 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 PL S g— OD�_(d
JOB ADDRESS: Z 7 q Y f� r�. PERmu# R E5A 17-ae;.,,
NEW OR REPLACEMENT INSTALLATION: Project Value oq,i5-0o' 00
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
i Floor Sink Toilet
Hose Bibs Urinal
' Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appl ianccs
Lavatory oZ 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 o Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
• Lawn Sprinkler System-Number of Heads n Well **
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other 13 C"+I,.T 0 to Ad d J t o�
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 1 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 TY /3 1; s Phone Number
Plumbing Company �,fr /��un h�^� �yL•Office Phone J�(1 -x(13 1 Fax
Co. Address: 1537 ,Po w Man t�• City3a X O ec o In State F L Zip 3d z 5o
License Holder(Print): 54j(le,5 sM��•fiG� State Certification/Registration#CFL N-96-I2
UU
Notarized Signature of License Holder
JENNIF OHNSTON Before me this_�_day of 9bO 1.« 20_1_�_
MY COMMISSION#GG 042984
EXPIRES:October 27,2020 Signature of Notary Public
Nota Public Underwriters g
,,E�,.•«oP� Bonded Thru ry