358 Plaza PLRS18-0159 '+ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J 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: PLRS18-0159
Description: 21 FIXTURES
Estimated Value: 7000
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 358 PLAZA
RE Number: 169971 0000
PROPERTY OWNER:
Name: NICKEL CHARLES B
Address: 358 PLAZA
ATLANTIC BEACH, FL 32233-5442
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: DREW HARTMANN PLUMBING, INC.
Address: 4331 CEDAR RD CA FREDERICK ANDREW HATMANN
ORANGE PARK, FL 32065
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 ^ c(�
Ph(9004)247-5826 Fax(904) 247-5845 PLk _
JOB ADDRESS: S J Q O/i/ Z PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ -7 0
TYPE oFFixTURE QTY TYPE oFFixTURE QTY
Bathtub 2 Septic Tank&Pit
Clothes Washer /. Shower Z
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 G Water Heater
Other Fixtures Water Treating System
RE-PIPE: qTfpEoFFixTuRE
TYPE of FixTURE QTY 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:
D Sewer Replacement D Back Flow Preventer D Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
D Lawn Sprinkler System-Number of Heads D Well
**SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
D 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 1 have read
this application and know the same to be have 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 f any her state or local law regulation construction or the performance of construction.
Property Owners Name^ �t!"�/ I/rIG S Phone Number 2 g— SOS'6
Plumbing Company P_eD //Ift /9 P VI77 4JYoffice Phone �fl 7—Y60r7 Fax 065/yfJr
Co. Address: V53 ! rere/t0-/L / city DAide State F zip 3zC'd' -i"_
License Holder(Print): ification/Registration# CFC /12Sb f
Notarized Signature of License Holder
siom atanr_wEacrs Sworn and subscribed before is 20_
.; EXPIRElsslonerr,MIS
u' a E%PIHEa:O:tot., ltlB Signature of Notary Public
Bended Thm airy Pusk UWem
JCash Register Receipt Receipt1
City of Atlantic Beach R5531f
ux v
DESCRIPTION ACCOUNTCITY PAID
PermitTRAK $207.05
PLRS18-0159 Address: 358 PLAZA APN: 169971 0000 $207.05
PLUMBING $202.00
PLUMBINGBASEFEE 455-0000-322-1000 0 $55.00
PLUMBINGFIXTURES 455-0000-322-1000 21 $147.00
STATE SURCHARGES $5.05
STATE DEER SURCHARGE 455-0000-208-0600 0 $3.03
STATE DCA SURCHARGE 45500002080700 0 $2.02
TOTAL • C $207.05
Date Paid: Friday,June 29, 2018
Paid By: DREW HARTMANN PLUMBING, INC.
Cashier: LE
Pay Method: CREDIT CARD 10
Printed:Friday,June 29,20184:10 PM 10f 1