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545 Atlantic beach Ct plbg permit ?S�Ily �3 I, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J -- ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 TOB INFORMATION: Job ID: 16-PLBG-2871 Job Type: PLUMBING ONLY Description: ELECTRIC - 25 FIXTURES Estimated Value: Issue Date: 12/27/2016 Expiration Date: 6/25/2017 PROPERTY ADDRESS: Address: 545 ATLANTIC BEACH CT RE Number: None GENERAL CONTRACTOR INFORMATION: Name: DARLEYS PLUMBING INC. CFC056702 Address: 4472 PHILLIPS HWY QA CARL LESLIE DARLEY Phone: - FEES: State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Plumbing Fixtures $175.00 Trade Permit Base Fee $55.00 Total Payments: $234.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach,FL 32233 Ph(904)247-5826 Fax (904)247-5845 1 Ca -PL6G -7-v7 j JOB ADDRESS: 5f A7,A-ate I)Ant Cf PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPEOFF)XWRE QTY TYPE oFFD rORE QTY - Bathtub Z Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan -- Drinking Fountain Slop Sink Floor Dram Three Compartment Sink _ Floor Sink Toilet -�--- Hose Bibs Urinal Kitchen Sink 1 Vacuum Breakers laundryTray Water Connected Appliances T_ Lavatory Water Heater Other Fixtures �_ Water Treating System RE-PIPE: v TYPEOFftavRE QTY TYPEOFF)XTuRE QTY Bathtub Septic Tank&Pit Clothes WasherShower — Dishwasher Shower Pan Drinking Fountain Slop Sink — Floor Dram 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 eats of 11)808) ❑ Lawn Sprinkler System-Number of Heads ❑ Well '* **S7RWD Well Completion Form.Completed form to be submitted to the Buil&g Department for final inspection.** ❑ Other Pwmh li coma void n work soon, not commence within ma sue moron penod or work rs suspea n or abandoned for be c I hereby tlwtIn rad this application and know the same to be true and wrrect All provisions of laws and ordinances governing this work will be complied with whether specified or not The permit does not give authority w violate the provisions of any other state or local law regulation wnslmction or the performance of constmdion. Property Owners Name Ow /?^-'S Phone Number Plumbing Company Q. • Offi phone1'4,a-4 ���" Fax B Co. Address: city dsaL]pwveState -Zip Q' License Holder(Print): State CertiScation/Regig"Ition# ('Fi2 Notarized Signature 0 Lieacae Hokin l2-4 da of Q�c.:...)%s- 20-1(- JOANNE 016 JO*NNE MENL Sworn andsubscribed beforee this day of Wary pualic-slab a/Florw commlaabn a cc 0212at Signature of Notary Public (IWE My Comm.Eapna Auo 29.2020 �1 °' BonOea lMou00 NZWON 11Ars,.