PLRS18-0150 (2)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: PLRS18-0150
Description: 20 FIXTURES
Estimated Value: 5200
Issue Date: 6/18/2018
Expiration Date: 12/15/2018
PROPERTY ADDRESS:
Address: 317 2ND ST
RE Number: 169779 0100
PROPERTY OWNER:
Name: JEFF GIVINS
Address: 3100 THOMPSON RD
TELFORD, PA 18969
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
JOB ADDRESS: 31? PI loud PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value S od
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
RE -PIPE:
Bathtub
Clothes Washer
Dishwasher
Drinking Fountain
Floor Drain
Floor Sink
Hose Bibs
Kitchen Sink
Laundry Tray
Lavatory
Other Fixtures
TYPE OF FIXTURE
Bathtub
Clothes Washer
Dishwasher
Drinking Fountain
Floor Drain
Floor Sink
Hose Bibs
Kitchen Sink
Laundry Tray
Lavatory
Other Fixtures
/
Septic Tank & Pit
Shower
Shower Pan
Slop Sink
Three Compartment Sink
Toilet
Urinal
Vacuum Breakers
Water Connected Appliances
Water Heater
Water Treating System
QTY TYPE OF FIXTURE 07'3'
_I__ Septic Tank & Pit Ak
Shower %°
Shower Pan .✓/A
/VA Slop Sink f✓bt
N/A Three Compartment Sink —
HylToilet
Urinal
_l___ Vacuum Breakers _fr______
v/A Water Connected Appliances B
# Water Heater ---1--
_ Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor (Trap)
❑ Lawn Sprinkler System -Number of Heads 0 Well
**
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
gallons (Requires 3 sets of plans)
❑ 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 certilj that 1 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.
444.05 Phone Number 1 BO -,191/34%4
Property Owners Name V
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
,s, 4 DAVINAR DICKERSON Sworn and subscribed before me th' / 5 day of J 20/ S)
Commission # GG 148032
Expires October 22, 2021 Signature of Notary Public �, h
t.eoF 0_0% Bordedrhm Budget NotsryBen lces