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110 Jackson PLRS18-0182YSr'L`)y 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: 110 JACKSON RD 172137 0000 PERMIT NO: PLRS18-0182 Description: 16 FIXTURES Estimated Value: 6000 Issue Date: 8/8/2018 Expiration Date: 2/4/2019 PROPERTY ADDRESS: Address: RE Number: 110 JACKSON RD 172137 0000 PROPERTY OWNER: Name: FORSYTH V ALLISON W Address: GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: MARCHAND PLUMBING INC. Address: 10139 BOOKWOOD FOREST BLVD CIA BENNIE GORDON PICKETT JACKSONVILLE, FL 32225 Phone: ]4 J1 I rl I�I:r7:7LLlli-E; 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 $7,500. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Reach. H. 32233 I` L518-01(3 R 41 /� 1'h (904) 247-5816 Fax (984)147-Sg43 1` F .loll ADDRESS: NEW OR REPLACEMENT INSTALLATION: Tim. uF FINICHf Qrr Badnuh Z ('lathe. \V:uher __... Shower Dishw:'6her _. Shover Pun Drinking Fountain Slop Sink Floor Drain 'three ('ongtanmcnt Sink fluor Sink Toiler How Bibs _ l0'inal T Kitchen Sink Latlndn' Trac _ _.. Water (',)affected Appliances I:umdn Illi% Water I leiter Lacaton _ Water*1 watinµ S),Icnl fixtures Other Fixtures RE -PIPE.: Project Values 6000 TI'pls of Fh\T('RE Septic Tank R Pit Shower Shower Nan Slap Sink I lace Compartment Sink iuilel Ilrioal Vacuum Breakers Nater ('offnected Appliance. Water hrearer Nater I realmg SyAcnt Trpi. o)� Fn'rrxe Qrr 1 1 ! / TYPE rr(' FLY71 RE �C Bathtub a Septic lank. R Pit Clothes Washer __... Shower Dishwasher _. Shover Pun Drinking Fountain Slop Sink Floor Drain 'three ('ongtanmcnt Sink Fluor Sink Toiler I ose Bibs _ l0'inal Kitchen SinkV' ...... Senrlm Breakers Latlndn' Trac _ _.. Water (',)affected Appliances I mason Water I leiter Other Fixtures _ Water*1 watinµ S),Icnl Q)'1' MISCELLANEOUS: Sewer Replacement (lack Flow Prerenlcr Urease hamcphn (I rap) gallons (Requires 3.,e1x r.f phim) Lawn Sprinkler System -Number of Heads Well ** ' **SIR BID Bell Cantl4vimn Fbrnr. Completed limn lobe submitted to the Building Department for final inspection.** Other I'cnuiI Iwamno wW It xprk Jot, not cninnleace x inner a ser thl. arplirxtiml atm knnx the .ImI:m he true and aon..I. All Dram. the p.Rmil 1(111+ mer 1%1 m{lia/ail1 e•.i,dul.•Ilmpr..I. property Owu—Yers Name —/4Ili Soy r Plumbing (enlpany t" Co. Address: VYZ'Z i.. License Holder (Print Linn. of I,n�.:md nrdinmmoa rmcming lhi• nark in he complial sill, W mhcr apttiti:d oLn _ WLr'/.r A.11 I. hm:d tax reynlarinn mnamMtiIM err the ryr( ^mors ntannaractiun. PSyTh _.. Phone Number rT, _ Office P`holIA04 �Q�J SN5$ Fav 2_�. ^� C'it•l..UrJy—_Stalcr� /ip tilate ('erlificatimulRcgh ration s. G"(b51�5 ;rP ICS r (',prnrcpl P�, _ h.nary Puaksln.anaaa Clore me this day (11"(I n _._ 2 CherylL PayOe^ nnuvn(Nn1:rn Pnbliv p� my Comm".. 181251 q Exai. 0211&2024 PERMIT 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 NO: PLRS18-0181 Description: 16 FIXTURES Estimated Value: 6000 Issue Date: 8/8/2018 Expiration Date: 2/9/2019 PROPERTY ADDRESS: Address: 110 JACKSON RD RE Number. 172137 0000 PROPERTY OWNER: Name: FORSYTH V ALLISON W Address: GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: MARCHAND PLUMBING INC. Address: 10139 BOOKWOOD FOREST BLVD QA BENNIE GORDON PICKETT JACKSONVILLE, FL 32225 Phone: 7 :ISI i ilT:-]:1LT\! (r72F 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 Hench. PL 223; n L S 0 I I'll 904)247-5826 Tac(904)247-'ill I" R co JOB ADDRESS: 1/0 zr e"On /?J- PERMIT # NEW OR REPLACEMENT INSTALLATION: Project Values_. ._S_/Ll/ Trl'E OF£ECTIrRE QIT TIPS OF£ATORE 071' Bathtub Z Septic Tank & Pit Clothes Washer Shotcer Dishwasher Shower Pan _Z7 Drinking Fountain Slop Sink -- ___Floor Floor Drain llace Compartment Sink Floor Sink Toilet 12 Bose Bibs :- Urinal _. Kitchen Sink Vacuum Breakers I:mndn l}ny Water Connected Appliances I.matan Water Heater Z_.. Other I isnfrcN_ Water Treating System RL-1111'E: TrPEOE£187'CRE QTr TITEOI',V1XItRE Q7'1' Bathtub -' - Septic lank R Pit Clothes Washcl Shower Dishwasher Shotcer Pan Drinking Fountain .:-_.._._ Slug Sink Floor Drain '1 Free Compamnent Sink Floor Sink Toilet (lose Bibs Urinal - Kitchen SinkVacumn Breakers_ Laundry Trm� Water Connected Appliances Lfvannv Water Heater _ Other Fixtures Water lhating System MISCELLANEOUS: Setter Replacement Back Pluto Preventer Grease lnter"ptor (I i'ap) gallons (Requires 3 sei. of ldans) Lawn Sprinkler System -Number of Heads Well ** *" S1RWD lPe'll ComIrletina !•loan. Completed form to be submitted to the Building Department for final inspection** Other Nanit beu,nm.. niJ if nod does not annnnncr within a zit aunah period nr work is ,upended or nhnolonal lin sit numtlrs. 1 hcmby e,rlif, that 1 hxva read ,hi, appiiaation and bn:e the smnc to ba tee pad unrea. All he aromplied a ill. apsili.J .,l 'Ihe Pcm:ir drerc n^r Mitrnn ami:. to t intoe the Pro. i.iatn�. of am other nl:ne or L,r,J Ia. repnlmion mn, motion nr rhe perfmm�mcc of ennwae�inn. Properly Owvers Nam^e�,V_ K�j /d/ -r �- _ _ Phone Number Plumbing,( ompany y`pr'Ci t Office I'\honegal Wnw Fax_ Co. Addmss: kQlzov _ .. 1YC _ ___ Ciq'!. alb _ _Stale %ip �.4��P_.-J License Holder (Print): � �g�(._ _ State (Chertifieation/Re'gii. m1ioon # �5-1-6 5 Notarized. " nature o / " FS old r lY�if..��yyP�"a`�^^ .N°` Novy PudicSWaol Fbnar ebur me this /_7dayol _. _ .__.._ 20 Cheryl L Payaen iunnforr• nl Nolnrc Pnblie raY Cwrmiaeion nn 18rR51 -- _..__..... Ey) Cher Paydw13