PLRS18-0152 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
(591',D19 INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NFJff DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0152
Description:
Estimated Value: 3000
Issue Date: 6/22/2018
Expiration Date: 12/19/2018
PROPERTY ADDRESS:
Address: 349 3RD ST
RE Number: 1698230000
PROPERTYOWNER'.
Nam: HOFFMAN DAVID A
Address: 349 3RD ST
ATLANTIC BEACH. FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Add,ess:
Phone:
Name: WAYNE CONN PLUMBING INC.
Address: 6915 W BEAVER ST
JACKSONVILLE, FL 32254
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,them 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 RVAC work
exceeds and estimated value of$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: _?L11 7-Al-r-d PERmrr MPLES19-61
fzesoa- WIT
NEW OR REPLACEMENT INSTALLATION: Project Value$_xk0__
TYPE oF FixTURE QTY TraEoFFXxTuRE QTY
Bathtub Septic Tank&Pit _T_
Clothes Washer I Shower _T_
Dishwasher I 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
PE-PIPE:
TYPE of,FixTURE QTY TYPE of,FixTuRE QTY
Bathtub Septic Took&Pit
Clothes Washer — Shower
Dishwasher — Shower Pan
Drinking Fountain — Slop Sink
Floor Dian — 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 D Back Flow Preventer Li C�ase interceptor(Trap) gallons(Requires 3 sets of plans)
o Lawn Sprinkler System-Number of Heads 0 Well
**SJRWD Well Completion Form. Completed—fo—ffnto be submitted to the Building Department for final inspection."
o Other
Permit becomes void if work does not commence within a sixrnoudi period or work is suspended or abandoned for six months.I hereby corfify that I have mad
this application and know the same to be me and coreact. 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 my qther state or local law regulation construction or the performance of construction.
Property Owners Name 461FFMftN � 7W(Vt D Phone Number
Plumbing Company A 11 ilk r Office Phone 3J3 Fax SAM-e
Co. Address: (D "--A City Tlor statot-t zip 3---10(
License Holder(Print): State Certification/Registration fi�g lW34V
No tarized Sign atu re Of L hc�_n se Holder 10
—TONI at �RGER Sworn and st bscribed before rl�ais of 20-L(-)
�o c..'%
".951
EXPIRES.ocaun 6.2019 Signature of Notary Public
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