410 Garden Ln plbg permit j yLy�.fv
s f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4113M FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0060
Description: PLUMBING 4 FIXTURES
Estimated Value: 0
Issue Date: 3/9/2018
Expiration Date: 9/5/2018
PROPERTY ADDRESS:
Address: 410 GARDEN LN
RE Number: 172020 5208
PROPERTY OWNER:
Name: TOOMER CURTIS W
Address: 410 GARDEN LN
ATLANTIC BEACH, FL 32233-4528
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: C W WOOD PLUMBING
Address: 1328 ROMNEY ST QA WALLACE SCOTT WOOD
JACKSONVILLE, FL 32211
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 P
Ph(904)247-5826 fax(904)247-5845 ks(O 00 6 D
JOB ADDRESS: ��`(� (j'G4 J-edl Z a,r! C' PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QT►' 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
C)
RE-PIPE:
r TYPE OFFIXTURE QTY TYPE OFFIXTURE QTY
i
Bathtub Septic Tank&Pit
I Clothes Washer Shower
Dishwasher Shower Pan
j Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatorq Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
Ei Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads CI 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 authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name 1 c.>a/n Pr Phone Number
Plumbing Company t� 6-1.) 1)C/ �ltiin�:� Office Phone741`1166d11 Fax
Co. Address: 3 Z F A om ✓ii _ 19 City -IT-axStateJ�GLi �Z
License Holder(Print): 6U, Scd ,-V
'J v OaZ/ State Certification/Registration# 4��G D!;! �,7
Notarized Signature of License Holder �'`' ��'D`'r
fore me this�! day of 20
.10,11 GINDI ESPERGER
MY COMMISSION#FF 949`'1 S nature of No Public
S;Ootoher 6,2QI9
EXPIRE
Pubhc Underwdwe s
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