1643 Atlantic Beach Dr plbg permit Amk
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
IV ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALLBY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-2406
Job Type: PLUMBING ONLY
Descipdon: install 23 new fixtures
Estimated Value:
Issue Date: 10/26/2016
Expiration Date: 4/24/2017
PROPERTY ADDRESS:
Address: 1643 ATLANTIC BEACH DR
RE Number. None
GENERAL CONTRACTOR INFORMATION:
Name: DARLEYS PLUMBING INC.
,CFC056702
Address: 4472 PHILLIPS HWY QA CARL LESLIE DARLEY
Phone: -
FEES:
Plumbing Fixtures $161.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $220.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORmA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 .b-PLBU - :.KOb
JOB ADDRESS: �67� dn"I"iu tya5!'ca/ A PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFbavRE QTY TYPE oFFIXTuRE QTY
Bathtub 1 Septic Tank&Pit
Clothes Washer 1 Shower
DishwasherJ— Shower Pan I
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
-
Hose Bibs Urinal
Kitchen Sink _I_ Vacuum Breakers
Laundry Trey Water Connected Appliances
Lavatory Water Heater I
Other Fixtures Water Treating System I
RE-PIPE:
TYPE oFFvcmRE QTY TYPE oFFmmAE 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 Trey 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 plana)
❑ Lawn Sprinkler System-Number of Heads ❑ Well `*
**S:IRWD 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 moors period or work is suspended or abandoned for six momhx I hereby certify that I have read
this application mud know the same to be true and correct All previsions of laws and ordinances governing this work%ill be complied with whether specified
or not 7-he permit does not give authority to violate the provisions of my other some or local law regulation construction or the performmice of construction.
Property Owners Ne 14, c 'i? "'s Phone Number
Plumbing Com pany �_Offi�ce Phone ?r4 I VRq Faxa -
Co.Address: LAI, , city 6 State Zip
License Holder(Print): State Certification/Registration# 0IFC05:1 Via.
o r' V ..is, ffi,.. 110lder LL
JOANNE MENL 29ri of �ryf�, 2016
Notary Public-State of Fooma Sworn and subscribed before mei 's y
Commlaabn*GG 02 VSI
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My Comm.Eapun Aug 29,2020Sigoatrae of Notary Public -
:. SmkedtWouga Nall NolYy Assn.