1624 Atlantic Beach Dr - Permit PLRS18-0113 j"bill-
r Jai,
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: PLRS18-0113
Description: Install 27 fixtures
Estimated Value: 8000
Issue Date: 4/27/2018
Expiration Date: 10/24/2018
PROPERTY ADDRESS:
Address: 1624 ATLANTIC BEACH DR
RE Number: 169505 1120
PROPERTY OWNER:
Name: RIVERSIDE HOMES OF N FL
Address: 414 OLD HARD RD STE 502
ORANGE PARK, FL 32003
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$7,500.
PLTJMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 C LRS t 87- Oil,
JOB ADDPJ9Z: b Z q AT U ANTIC REACA PERMIT# RAS 1 a-oa5
NEW OR REPLAMAENT INSTALLATION: Project Value$ R600
TFPE OFI'DavRE QTY TYPE oFFD avRE QTY
Bathtub 3 Septic Tank&Pit
Clothes Washer I Shower
Dishwasher jShower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bilis Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray Water Connected Appliances I
Levator' Water Heater _ -
Other Flxrures Water Treating System I _
RE-PIPE:
TYPE OFF aURE QTY TYPEoFFLavRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shbwer 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
NMCELLANEOUS:
o Sewer Replacement o Back Flow Preventer o Grease lnterceptor(Trap) gallons(Requires 3 sets of pia
o Lawn Sprinkler System Number of Heads o Well . **
**S.IRWD Well Completion Form.Completed form to be submitted to the Building Department for final mspectior
o Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for sic months.I hereby certify that I have
this application and know the same to be true and cmTea Ali provisions of laws and orftanm govemmg this work will be courplied with whether specb
or not. The permit docs not give authority to violate the provisions of any other state or lomi law regulation construction or the performance of constr c c
Property Owners Name zi VCxSI 0i HOME'S Phone Number
Plumbing Company /1471-S oN P�u mt3 iW A, 1 _2-p SNL ._Office Phone Z6 Z. V 6 BY Fax
Co.Address: B.67-q -j DAvis C' State -, Zip 3 Zen
License Holder(Print): o o�.Jj#on/Registration# (7 0 3 7
N i older
IDSA P.BASS ILL,
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:.; MY COMMISSION#FF 900342 Sworn and subscribed be a me Af '�^'� , 2dEXPIRES:November 16,2019L1Bonded Thru Notary PubGe UndenmtarsSlgllature Of Notal y PtJ t)11C +L--