1965 Brista De Mar PLRS18-0163 ? CITY OF ATLANTIC BEACH
9
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: PLRS18-0163
Description: REPIPE 13 FIXTURES
Estimated Value: 2100
Issue Date: 7/11/2018
Expiration Date: 1/7/2019
PROPERTY ADDRESS:
Addresn 1965 BRISTA DE MAR CIR
RE Number: 169506 1668
PROPERTY OWNER:
Name: MCGUFFIN GERALD R
Address: 1965 BRISTA DE MAR CIR
ATLANTIC BEACH, FL 32233-4525
GENERAL CONTRACrOR INFORMATION:
Name:
Address:
Phone:
Name: AFFORDABLE PLUMBING COMPANY OF
Address: 4545 ST AUGUSTINE RD CIA ROBERT SCOTT CHICOSKI
JACKSONVILLE, FL 32257
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 stats 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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
(; II P`h((904)247-5826 Fax (9n044)/214'r7-5845 �L RSI - 6I rd3
JOB ADDRESS: I -1 N S V 7 cl S no �)'6 �/r l.ul.l C1 it, PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$_Z__(00
TYPE oFFIXTURE 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:
TYPEoFFtxTURE QTY TYPEOFFixTURE 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 '*
**SIRWD Well Cotpletion Form. omple fo��""�to be bmitted to the Building Department for final inspection.**
❑ Other pl l \S �t Y.'_y M
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
an other state or local law mguhmon construction or the performance of construction.
Property Owners Name in p P A C' Y'Ct V.� Phone Number
Plumbing Company {�f-F'�tr cent c�`l^e lU'V/LI C Nw e D � OfficePhone2 Dp 603 Fax r�
Co. Address: Ut( (aS Sv• A06 'l-6 , City V�4X Sta[eVl%_AZip 3u0?tr�
License Holder(Print): J to Certifiction/Registration# C� 0 _1 ZZL
Notarized Signature of License Holder s • 4 S
roa GINeuss,'RaIR Swom and subscribed before m is of 201Q
MV COMMIssoNiFF9n961
E%'IRES:Ocrober 6,2019
'y,,..;t•. 9mmXPIRES odo ober
6, 9 Signature of Notary Public