1631 ATLANTIX BEACH DR - PLUMBING '3 i�\Jr\ ''s
CITY OF ATLANTIC BEACH
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800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
I >V INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS18-0195
Description: 19 FIXTURES
Estimated Value: 9600
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 1631 ATLANTIC BEACH DR
RE Number: 169505 1085
PROPERTY OWNER:
Name: ANN T SANTAYANA REVOCABLE LIVING TRUST
Address: 1886 BEACH AVE
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: SUNSHINE STATE PLUMBING
Address: 1340 TRAILWOOD DR MICHAEL TROY PORTER
NEPTUNE BEACH, FL 32266
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 /D L R S( b -0( 95
JOB ADDRESS: 1631 ATLANTIC BEACH DR. PERMIT# RES 18-0147
NEW OR REPLACEMENT INSTALLATION: Project Value$9600.00
TYPE OF FIXTURE QTY TYPE OF FIXTURE QT}'
Bathtub 1 Septic Tank&Pit
Clothes Washer 1 Shower 2
Dishwasher 1 Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs 2' Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray Water Connected Appliances 2
Lavatory 5 Water Heater 1
Other Fixtures (� Water Treating System
RE-PIPE: \_ \
TYPE OF FIXTURE 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
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ 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 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 any other state or local law regulation construction or the performance of construction.
Property Owners Name Lisa Pelkey Phone Number 904-521-4858
Plumbing Company Sunshine State Plumbing Office Phone 904-262-1066 Fax 904-262-0358
Co. Address: 710 Haines Street City Jacksonville State FL Zip 32202
License Holder(Print): Michael T. Porter State Certification/Registration#CFC 1426859
Notarized Signature of License Holder MK
'J day of
o, ,RY PUgc DAVINAR DICKERSON ill i't"s�
20
Commission#GG 148032 Sworn and subscribed before me this
� Expires October 22,2021
m'rF oeBonded ThtuBudget Notary senices Signature of Notary Public
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