1817 ATLANTIC BEACH DR - PLUMBING ,, ' CITY OF ATLANTIC BEACH
'S",,,:,,v,..,..„,
,c) 800 SEMINOLE ROAD
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ATLANTIC BEACH, FL 32233
.7!0;3 9%' INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0043
Description: install 32 fixtures
Estimated Value: 10000
Issue Date: 2/20/2018
Expiration Date: 8/19/2018
PROPERTY ADDRESS:
Address: 1817 ATLANTIC BEACH DR
RE Number: 169505 1515
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: NELSON PLUMBING CO. INC.
Address: 11624 -1 DAV E DAVIS CREEK RD QA SCOTT GARY NELSON
JACKSONVILLE, FL 32256
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$7,500.
1C,
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 PL-12 Si _Vo3
JOB ADDRESS: (81-1 -LLA..rri C RE-ft-A DR_ PERAirr# Res ti-c tl
NEW OR REPLACEMENT INSTALLATION: Project Value$ I o 0o D
TYPE OF FIXTURE - QTY TYPE OFFIXTT RE QTY
Bathtub Z Septic Tank&Pit
Clothes Washer I Shower 4
Dishwasher _____L__ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet �_
Hose Bibs _____ Urinal
Kitchen Sink ______L_ Vacuum Breakers
Laundry Tray _ Water Connected Appliances —I--
Lavatory _�__ Water Heater ___Z__ -
Other Fixtures Water Treating System
---I--
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:
o Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of pla
❑ Lawn Sprinkler System-Number of Heads 0 Well - **
**S.IRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection
O 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
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 specii
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 constructic
Property Owners Name 12 CV )t t i D t 1(o wt els Phone Number
Plumbing Company /VC/sc.., R....,4/1,05 (o .2.,c Office Phone 2-62. 't 8 9 tt Fax
Co.Address: II 4.2 '{ -( OA Ji.‘ Ceti f.l.f
2D C i, 'S lic ice e.4 J I 1 e2 State Zip 322,rE
License Holder(Print): c c o TT A-)6 SO../ / I ` I - Certification/Registration# O Z-D 37
Notarized Signature of License Holder I t�,,A'iariri �
r,- w1►_ ♦.w ♦ / r ✓ 20)
(491K ; USA P•BASS Sworn and su• a before me ,' g' da. :a MY COMMISSION t FF 900342 f-�, EXPIRES:November 16,2019 ub /^ , /� lt;i obc. Bonded Thru Notary Pubic Underwriters Signatureof Notary Public Y+"'