110 Jackson PLRS18-0181PERMIT
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:
PLRSIB-0181
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 QA BENNIE GORDON
PICKETT
JACKSONVILLE, FL 32225
Phone:
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 [leach. FL 32233 P L � S, C O
I'll
(904) 247-5826 Frux (904) 247-5845 c3 -01e)
I
JOB ADDRESS: ��n 3-.IKSOf\ /CIX PERMIT #
NEW OR REPLACEMENT INSTALLATION:
Project Value $._,._ - --
Tri -f. or£irPRE
Qrr
rE
Tror FtxruRE Qn,
Bathtub
Z
Septie Tank K Pit --_-
('lathes Washer
_.
Shower
Dishwasher
Shower Pan
Drinking rounlain
Slop Sink -
Hoar Drain'I
lace Compartment Sink _
Roar Sink
_
Toilet
Haw Hibs-
Urinal
Kitchen Sink -
VaCU11111 Breakers _z_
Laundn l7av
- -
Water 'onncctcd Appliances
(
Lm'aton'
_
Water Heater Z
Other Fixture,
. __. _.,
- N'an•r l icating System _
Rh: 1'11'li:
Trrto£F'acrcxrr
Qrr
TYPE nr'FIXTURE Qrr
Bathtub
Septic I ank K Pit
Clothes Washer
Shower _.
Dishwasher
Shower Pan -
Drinking fountain
_.
Slop Sink
Fhwr Drain
'fhnc Compartment Sink
Floor Sink
Toilet -
(lose Bibs
urinal _..
Kitchen SinkVacuum
Breakers
Laundry TrawWater
_ _..
Connected Appliances
Lawami)
Water Heater _.
Other Fixtures
Water Treating System ....
MISCELLANEOUS:
Sewer Replacement Hack Flow Plewrnter Grease Interceptor (I imp) gallons (Requires 3 sets of plats)
Lown Sprinkler System -Number of Heads Well ** ,
"" .VRIID Well ( •omplelimr P1mm. Completed form to be submittal to the Building Department for final inspection."
Other _
1'cnuil M1ecnmc. uiJawnmond prnnuornnc,snepcnu:.orao.aouruca nn w.-ou..... .... .... ,...... ; .—..._....
fir, applio'non:md to.... ancesememinnthianork t,ill be compliwt t60, Mather spceired
m nm. the permit Arcl ori pito nuthorin to t iolalc Or, I`n., i.ion. of am other cne or Loral lull regulation cnnstroakat or the perlimnunce of wnWn rtion.
Property Owtim Nan^ic\�, V(X11,SS�OyN `" TT��_� ---... _---- Phone Number--
Plumhing('nntpan}'1=�rLS'`pr`G C,4�1 .�{t1.. _ Office Puc�
la0'1
6'8155 Fax_ _-_y._-�.-.�_�.
Co. Address:IQ� g_. �V ____._ ('iq'E..J�w�_ _S,ab:FL ,ip�y.��.��G
License Holder (Print): �. ({��(�,) __ State (CerliBcatiot/Regi.. ration
Netadzed.Si turtneerre f ff ru.{e llolflnc \7t'iY.1t2i�q� I t "'•'e
,r•' naan Paam stabaElMOa Clive me this/"�eiur ul
•P CheMLPaytlen 6.nnbnr nY hRu:m•Pnhlic
S.140
E:Whes ]It812an 1aT25� ` ��
5 rii�L`l7Jn
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: PLRS18-0182
Description: 16 FIXTURES
Estimated Value: 6000
Issue Date: 8/8/2018
Expiration Date: 2/4/2019
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 CIA BENNIE GORDON
PICKETT
JACKSONVILLE, FL 32225
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 govemmental 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.
JOB ADDRESS:
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
81111 Seminole Rd Atlantic Reach. 171. 31-211 1` L RSl8
Ph(904)247-5826 Fax(904)247-5843 �` F O 1
_ n
Jac rson I1CC PERMIT N
NEW OR REPLACEMENT INSTALLATION:
Tm_aFFZvwRE
QT1'
Bathtub
Z
Clothes Washer
--_-- Shona'
Dishsasher
Pan
Drinking Fountain
Slop Sink
Floor Drain
three Compartment Sink
Sin k
_- Toilet
Hose Bibs
flow
Iit incl
Kitchen Sink-
Kitchen Sink
Latmdn Trac
%Nater Connected Appliance.
I Ando 'I me
Water I leacer
I.asatoiA
_ Water Treating S)slcm
Other fixtures
RE -PIPE.:
Project Values 6000
Tt'PI: w Ftrxrt RE
Septic 1 ank M Pit
Shos.cr
Shosser Pan
Slap Sink
(lace Compartment Sink
Toilet
Urinal
Vacuum Breakers
%Vater Connected Appliances
Water Beater
N':aer I waling Ss.tcm
TITS OF FISTFRE
QTY T7PEOFF'LN7l'RE
Bathmb
Septic Tank R Pit
Clothes Washer
--_-- Shona'
UishnasherShmcer
Pan
Drinking fountain
Slop Sink
Floor Drain
three Compartment Sink
Floor Sink
_- Toilet
I lose Bibs
Iit incl
Kitchen Sink-
Vacuum Breakers
Latmdn Trac
%Nater Connected Appliance.
Unman
Water I leacer
Other fixtures
_ Water Treating S)slcm
MISCELLANEOUS:
Seater Replacement Back plop Presenter Grease lnlereeptoi 1 I rap) gallons (Requires 3 sets of phws)
Laren Sprinkler System -Number oCl leads Well ** ,
.1. SIRIPD Il'ell Cmilpletioa Euro(. Completed Corm to he submitted to the Building Department for final inspection."
Other
N.I14 beannc,'oil] it aork Joo not CpinnIIIIII x num a en mol . p.n n. o, ..
thi,application and Knox the .ame to h: tnie:md corn. 1. All Pro, 6i.nr. oflau,
or run. 1 he perrniI da, n,,, ii.. nunuviry e,. rotate I n• pro. iNil to,
oro, other
Property Ooncm Name
Plunthing(rnnpnm j�(`�•`Qr� {"%s�Vl yf +C.
('it. Address:
License
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and nnlinlncc: co.crninr ihi...... A rill he compli,A..inh..lmthcr ap¢ilie,l
L•..JI:n.rer,dnhm con,iru;tinn orthe iwrtoroare< of onxtomio,
Phone Number _.
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e this _ 7.6—day of _ _... 220
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