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443 Whiting Ln plbg permit ' CITY OF ATLANTIC BEACH 1 '� 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: PLRS18-0115 Description: Install 4 Fixtures Estimated Value: 1850 Issue Date: 4/30/2018 Expiration Date: 10/27/2018 PROPERTY ADDRESS: Address: 443 WHITING LN RE Number: 171438 0000 PROPERTY OWNER: Name: BRADLEY CLYDE W JR Address: 443 WHITING LN ATLANTIC BEACH, FL 32233-3912 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: PIPE WORKS LLC Address: 11233 Wesley Lake Dr Joseph Cantios JACKSONVILLE, FL 32220 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$7,500. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904)247-5826 Fax (904) 247-5845 JOB ADDRESS: �� t l� f.� d (6t GZ �(� PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value$ 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) ❑ Lawn Sprinkler System-Number of Heads ❑ 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 �Wfn [NrGdl�'1 Phone Number Plumbing Company P`t•-f LVary.3 a C Office Phone Fax Co. Address: ) Q2 3 W-t fa�c 1N City Ja.F State f, Zip �??Z License Holder (Print): )0f 6 0tS State Certification/Registration# Notarized Signature of License Holder �.�,...... Sworn a d subscribed before me this day of Apn 20 JENNIFERJOHNSTON MY COMMISSION#GG 042984 Signature of Notary Public EXPIRES.October27,2020 Bonded Thru Notary Public Underxriters J a f Cash J S) Register WCity ofAtlanticBeach DESCRIPTION • QTY PAID PermitTRAK $87.00 PLRS18-0115 Address: 443 WHITING LN APN: 171438 0000 $87.00 PLUMBING $83.00 PLUMBING BASE FEE 455-0000-322-1000 0 $55.00 PLUMBING FIXTURES 455-0000-322-1000 4 $28.00 STATE SURCHARGES $4.00 STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00 STATE DCA SURCHARGE 45500002080700 1 0 $2.00 TOTAL 'A . , . $87.00 CITY OF ATLANTIC BEACH 800 SEMINOLE RD ATLANTIC BEAC,FL 32233 �:+3012018 16:55:03 CREDIT CARD VISA SALE: CARD# ;WX)0(XXXXXI(4289 INVOICE 0005 SEQ#: 0005 Batch#: 000787 Approval Code: 038511 Entry Method: Malnlal Node: online Tax Amount: $0.00 Card Code: M SALE AMOUNT $871 ri irTMACn r(ZV Date Paid: Monday, April 30, 2018 Paid By: PIPE WORKS LLC Cashier: CB Pay Method: CREDIT CARD 038511 Printed: Monday,April 30,2018 4:56 PM 1 of 1 rwu�T