1885 Sea Oats PLRS18-0164 r1 y:L`17 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: PLRS18-0164
Description: Water Heater
Estimated Value: 875
Issue Date: 7/17/2018
Expiration Date: 1/13/2019
PROPERTY ADDRESS:
Address: 1885 SEA OATS DR
RE Number: 172020 0534
PROPERTY OWNER:
Name: FULTZ GARY L
Address: 1885 SEA OATS DR
ATLANTIC BEACH, FL 32233-4511
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: ASAP PLUMBING & DRAIN CLEANING
Address: P 0 BOX 48070 SD SERVICES OF JACKSONVILLEIP. 0. BOX
48
JACKSONVILLE, FL 32245
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
QXr Ph(904)247-5826 Fax(904)2247-5845
JOB ADDRESS: IOSS �'eo, Ocfs Dr. PERMIT I�.S(�-6((ey
NEW OR REPLACEMENT INSTALLATION: Project Values
TYPE oFFIXTORE QTY TYPEOFF)YTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Twee 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:
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
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 Cl Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler 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 Nat I have mad
Nan
is application d know Ne same to be true and correct. All provisions of laws and ordinances govenning this work will be complied with whether specified
or not. The permit does not give authority to violate the provisions of any other state or local law regulation conetmetion or the performance of construction.
Property Owners Name borlem o Phone Number 90'/1//2 q 32 1
Plumbing Companyp �VWsbi/�gi Office Phone ?W99T3'i33 Fax
Co. Address: D 6 C O city J6 State FL Zip 3--
License
2License Holder(Print): _ State Certification/Registration it CFCO SG 6 S'3
Notarized Signature of License Holder
Pr� Nater,oaMic awte a MNa Before me s day of 20
Oertnaen
"y) -aZaubn pc,eozeo Signature of Notary Public
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