1781 ATLANTIC BEACH DR WATER TREATING 1U
11
CITY OF ATLANTIC BEACH
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: PLRS18-0067
Description: 1 WATER TREATING SYSTEM
Estimated Value: 0
Issue Date: 3/19/2018
Expiration Date: 9/15/2018
PROPERTY ADDRESS:
Address: 1781 ATLANTIC BEACH DR
RE Number: 169505 1485
PROPERTY OWNER:
Name: RIVERSIDE HOMES OF NORTH FLORIDA INC
Address: 414 OLD HARD RD STE 502
FLEMING ISLAND, FL 32003
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: AFFORDABLE WATER/KINDER INC
Address: 3760 KORI RD SPECIALTY WATER (CONS TDS QB)
JACKSONVILLE, FL 32257
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
1�
JOB ADDRESS: 1'781 -r4 o�+r/T i c Beach DR 1 LI e, PERMIT#
/If"ma7c ZkacL h 32 33
NEW OR REPLACEMENT INSTALLATION: Project Value $
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 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)
�, Sprinkler System-Number of Heads [I Well
**
SJR WDmnletion Form. Completed form to be submitted to the Builc ing 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.
Phone Numbers/3"1 q 8-773 3
.Property Owners Namesn J�'a'IM-M i�, ��`
ilumbing Company H rr-01Z DABLfE ��� Office Phoneclob2-n19Fax-- ' 2 2
Co. Address: Z'7CoD KO j20a�-VJ City kksoi1Ut1le- State FL Zip 322-59
License Holder(Print): m A 12 K 1q • K)tiDEJZ State Ce ification/Registration#_000 618(0
Notarized Signature of License Holder
Sworn and subscribed be me this l5 day of M6wc 2018
yimte of fbridavore Signature of Notary P licGG 081383
21