395 8TH ST - WATER HEATER CITY OF ATLANTIC BEACH
I,►j '=`'' - 800 SEMINOLE ROAD
:4 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: PLRS18-0069
Description: WATER HEATER
Estimated Value: 0
Issue Date: 3/22/2018
Expiration Date: 9/18/2018
PROPERTY ADDRESS:
Address: 395 8TH ST
RE Number: 169983 0000
PROPERTY OWNER:
Name: GRAY ADAM R
Address: 826 9TH AVE N
JACKSONVILLE BEACH, FL 32250
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.
z„------21P-7
0 PLUMBING PERMIT APPLICATION
�I °' CITY OF ATLANTIC BEACH
,..: G� 800 Seminole Rd Atlantic Beach, FL 32233 , v_v OGC
L'`,.2 Ph (904) 247-5826 Fax (904) 247-5845 �s
JOB ADDRESS: 8 a5 8 h e r'r y Dr,ve Aft-an bc. `Beach PERMIT#
3 9.,A'a3
NEW OR REPLACEMENT INSTALLATION: Project Value $Co(o.00
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System _1_
RE-PIPE: •
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer ,Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads 0 Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
O Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read
this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or aiot. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Q oY.�02 -L�3�-
Property Owners Name
/darn G R CL
Plumbing Company A FFO R.1>A$Lt. WA 4-Eg Office Phone 9 7 Fax�0 670---60•292-
Co.
o0— 292Co. Address: 3'7. o KBO f2 i R O cJ City jAcksonu 1 I le. State FL Zip 02.259
License Holder(Print): MARK R • K i ti D t State Ce ification/Registration# 0006)8(a
Notarized Signature of License Holder Ar # -. -:1
Sworn and subscribed be me this I R day of March 20 18
je Notary Public State of Florida (� 41/
Dorothy M.Devore Signature of Notary P lie
►_1.�.,�'L e 1
My Commission GG 061383 411�?or r,a Expires 02/09/2021