1619 ATLANTIC BEACH DR PLBG PERMIT ATLANTIC BEACH
C PERMIT RECEIPT
PERMIT DESCRIPTION: install new washer,2 tubs,dishwasher,hose bib, sink,6 lavatories,3 shower
pans,5 toilets,water heater
PERMIT NUMBER: 16-PLBG-1653
ADDRESS: 1619 ATLANTIC BEACH DR PA/1)
OWNER: C/7), jk el Z815
DATE ISSUED: 4r4AlVpIC 8&ICH
FEES DUE:
State PLNG—DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
CITY OF ATLANTIC BEACH
Plumbing Fixtures $140.00 600 SEANOLE RD
ATLANTIC BEAC,R 3W3
Trade Permit Base Fee $55.00 07,21,2016 CREDIT CARD 15:18:44
VISA SALE
CARD Y x)(UND=026
Totals: INVOICE 0005
$199.00 SEQ;: 0005
Bakh#: 000362
Approval Code: 092929
Enlry WdW: Maui
MD*: Onlax
Tax Aawrt: $0.00
Card Code: M
SAUE AMOUNT $M.W
CUSTONER COPY
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NE]ff DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 16-PLBG-1653
Job Type: PLUMBING ONLY
Description: install new washer, 2 tubs, dishwasher, hose bib, sink, 6
lavatories, 3 shower pans, 5 toilets, water heater
Estimated Value:
Issue Date: 7/21/2016
Expiration Date: 1/17/2017
PROPERTY ADDRESS:
Address: 1619 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMA77ON:
Name: CANNON PLUMBING, INC.
Address: 1794 -1002ROGERORD QAOLINMARSHALL
CANNON
Phone:
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $140.00
Trade Permit Base Fee $55.00
Total Payments: $199,00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CffY OF ATLANTic BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845 Ila- PI-190) - la�
JOB ADDRESS: A41,a,,+.-(- Rzaejl Dr. PERmTr#
NEW OR REPLACEMENT INSTALLATION: Project Value$
Typz�or Fj=RE QTY TYPEoFFmIruRE OTY
Bathtub k&Pit
Clothes Washer Isepolwiler'"
Dishwasher Shower Pan
Drinlk�=ntain
Floor Slop Sink
Three Compartment Sink
Floor Sink Toilet
How Bibs Urinal
Kitchen Sink Vacum Breakers
Laundry Tmy Water Connected Appliances
=ry L Water Heater
Fcetures Water Treating System
RE-PIPE:
TYPE oF FarvRE QTY TYPEoFFUTuRE (?TY
Bathtub — Septic Tank&Pit
Clothes Washer
Dishwasher — Shower
Drinking Fountain Shower Pan
Floor Dol' — Slop Sink
In — Three Compartment Sink
Floor Sink
Hose Bibs — Toilet
Kitchen Sink — Urinal
— Vacuum Breakers
Laundry Tray Water Cannetted Appliances
Lavatory Water Heater
Other Futtures Water Treanng System
MISCELLANEOUS:
ClSewaReplaoismant []Back Flow Preventer 0 Grease Interceptor(Trap)_gallons(Rerjulra;3 sets of plans)
D Lawa Sprinkler System-Number of Heads 13 well
**SJRWD Well Completion Form. Completed—fo—rmto be submitted to tEh7ffmWS Department for final inspection.**
ii Odier
Perniftbeconnesvold If work does 044COMonvace whin Ash,Month penodorwri,is suspended orabandoned forsm ronnabs.I hereby ratirethm I hinread
this application and knovv the earn to be new ad corcrL All provisions of laus and ordinenees governing this work will be complied with vhesher speeifled
or not. The pomit does not Ove authority to violen the provisions of my other sta,or lood 1�regWation nonstruction 0,the perfornnanoc of construction.
Property Owners Name Phone Number
Plumbing Company Cannan &01b�j XAg- office Phone 10,7#0.t.V# Fax qot.$V-OfI4
Co. Address: I?lr 15. 01ftlah S+ City State P/ Zip 3,1101
License Holder(Print): 0410 nt�tjil)wj statecertification/Registrationg CFCt+,xGi*
Nota rked of Liceme Holder
L"LmEDUEE F Sworn and subscribed before a 4ay of T,�� 20J(0
E�01,ft Joy 23,me
cons �*: i4m
to
Signal=of Notary Public