180 Sandy Beach Ln PLRS18-0166 plbg permit -S r1,y:r
CITY OF ATLANTIC BEACH
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: PLRS18-0166
Description: Install new Fixtures (10)
Estimated Value: 10
Issue Date: 7/19/2018
Expiration Date: 1/15/2019
PROPERTY ADDRESS:
Address: 180 SANDY BEACH LN
RE Number: 173414 0160
PROPERTY OWNER:
Name: BEACHES HABITAT FOR HUMANITY INC
Address: 797 MAYPORT RD
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: ADVANTAGE PLUMBING
Address: 880 MAYPORT RD CIA GREG GAUSE
JACKSONVILLE BEACH, FL 32240
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$7,500.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 Ry 5, n
JOB ADDRESS: 1!7 �A,v�t� r7� h PERMTT# /7 -DoZ-3l
ptaesrx -or�8
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE oFFIXTURE QTV
Bathtub 1 Septic Tank&Pit
Clothes Washer —� Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink 1)
Floor Drain Thee Compartment Sink
Floor Sink Toilet
Hose Bibs —� Urinal
Kitchen Sink t Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 2. Water Heater I
Other Fixtures Water Treating System
RE-PIPE:
TYPE OFFDrTORE QTY TYPE OFF/XTURE 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 Spnnklef System-Number of Heads ❑ Well ••
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ 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 one and correct All provisions of laws and ordinances governing this work will be complied with whether specified
or not no permit does not give authority to violate the provisions of any other slate or local law regulation construction or the performance of construction.
Property Owners Namerr 1" Qt W Phone Number
Plumbing Company,1Cr�/Aj TlNqO �IUeI'I�/NG OfficePhoneay798y8 Fax
Co.Address: AART RdL City State tq Trp 2235
License Holder(Print): State Certification/Registration#CfAI` Sgs9
Notarized Signature of License Ho 1,Z, '
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Swom and subscri ed before me ylof 20E
� '= MYCOMI MISSeION�FF 924951 Signature of Notary Public 1
: R EXPIRES'.OCIoCe:6,2019
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