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1875 HICKORY LN - PERMIT PLRS18-0093 i riy�`lr,� CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 "�`�;•3>>� INSPECTION PHONE LINE 247-5814 PLUMBING RESIDENTIAL - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: PLRS18-0093 Description: 8 FIXTURES - revised 5/14/18 Estimated Value: 1500 Issue Date: 5/14/2018 Expiration Date: 11/10/2018 PROPERTY ADDRESS: Address: 1875 HICKORY LN RE Number: 172020 1430 PROPERTY OWNER: Name: PRICE ROBERT W Address: 1875 HICKORY LN ATLANTIC BEACH, FL 32233-4548 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: FOSTER PLUMBING, INC. Address: 2905 HODGES BLVD QA STEPHEN HAROLD FOSTER JACKSONVILLE, FL 32224 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$7,500. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 247-5826 Fax (904) 247-5845 PL VSI 0 .JOB ADDRESS: JS—?-3s PERMIT NEW OR REPLACEMENT INSTALLATION: Project Value$ 1_50c _o TYPE oFFIXTURE QTY TYPE oFFIXTURE 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 oFFIXTURE QTY TYPE oFFIXTURE 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 k xx SJR WD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.*X ❑ 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 pp-1 e-'E_7 Phone Number Plumbing Company FST JFLU M Q/aJG <'Q Office Phone g�l-0-70.7 Fax Co. Address: Z�� RC( 0 6'6y'- ��, City �� State f Zip License Holder(Print): Ste' i,( � -'O _AEa6_, St ifi ati n/Registration# C7F7coSC1 SE Notarized Si nature . lder 441111P11 JENNIFERJOHNSTON AV,'- MY COMMISSION#GG 042984 Sworn and subsc ibed before me this�_day of AOL" 20- "`' EXPIRES.October 27,2020 _> •••oP i3ondedThruNotarYPublicUndeM461tere Signature of Notary Public -