PLRS18-0151 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXr DAY INSPECTION: 247-S814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0151
Description: New Plumbing Fixtures
Estimated Value: 6000
Issue Date: 6/20/2018
Expiration Date: 12/17/2018
PROPERTY ADDRESS:
Address: 346 8TH ST
RE Number. 1699300000
PROPERTY OWNER:
Name: AHO GAY FAMILY TRUST
Address: 346 8TH ST
ATLANTIC BEACH, Ft.32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: KOS VENTURES LLC
Address: 4341 N RED TIP RD KURT SCHLUP
JACKSONVILLE, FL 32218
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 Rd;7S-,J le_�ODII
JOB ADDRESS: 3 Y& rX 5,�, PERMIT# "St
NEW OR REPLACEMENT INSTALLATION: Project Value
TYPE oF FixTuRE QTY TYPEoFFixTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Fluor Sink Toilet
How 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 TYPEOFFixiuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
How Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
17 Sewer Replacement Ei Back Flow Preventer u Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Li Lawn Sprinkler Systend-Number of Heads El Well
**VRWD Well Completion Form. Completed—fom to be submitted to the Building Department for final inspection."
Ei Other
permit becomes void if work doesmaccournence within a six month period or work is suspended or abandoned for six months.I hereby"nify that I have read
this application and know the same to be trac msd correct. All provisions oflaws and ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to violate the previsions of my rather some,or local law regulation construction or the performance of consuraction.
Property Owners Name e '/ ;n'�r-,— Phone Number
1 1 A4!�? CV /:;�01" %
Plumbing Company 1* Z-/-e- Office Phone(-�;?6- 3VZ-3 ax_
Co. Address4e:W/ O&o noo A0 ,Vy,2w.4 City State,�/ Zip,?2 2-/,f
License Holder(Print): State Certification/Registration M��/ �M
Notarized Signature o Licens older
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A JEWFER JOH""T
W CM_, Sworn and subscribed before th* of aA(\.0 20
MAM I ,CWMSSJo,,#GG04n�
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Signature of Notary Publi
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