370 PLAZA PLRS22-0084 Plumbing Permit Application **ALL INFORMATION
/•-r s.. /:•;.\ HIGHLIGHTED IN
""\ City of Atlantic Beach Building Department GRAY IS REQUIRED.
'` 800 Seminole Rd, Atlantic Beach, FL 32233 P Lid SZ
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 370 Plaza PROJECT VALUE $14,800.00
✓❑VEW OR REPLACEMENT INSTALLATION and/or EIRE-PIPE
,TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer 1 Shower 2
Dishwasher 1 Shower Pan 2
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs T Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray 1 Water Connected Appliances
Lavatory 4 Water Heater 1
Other Fixtures z/ \Water Treating System 1
❑VIISCELLANEOUS
❑Sewer Replacement
❑Back Flow Preventer
❑Lawn Sprinkler System (number of sprinkler heads)
Drease Interceptor (Trap) gallons (Requires 3 sets of plans)
Well **SJRWD Well,completion Form.Completed form to be submitted tp the Building Department for final inspection. **
❑Other replace cast iron rerouted water lines Permit RES22-0151
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.
Owner Name:Kimberly Troy Phone Number: (410)375-9498
Plumbing Company: SnydeeCo Office Phone: (904)641-0699 Fax
''1Co. Address: PO Box 16826 City: Jacksonville State: A Zip: 32245
License Holder: John Zellner State Certification/Registration # CFC1427375
Notarized Signature of License Holder i tutI.A#\
'
The fore o ' strurient wps acknowledged before me this 7 d. e ilk a , 202 he State of Florida,
County of 1 JCL 0
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''l,...";*;,....._ TONIGINDLESPERGER Signature of Notary Public ��- -
=.: 4 MY COMMISSION#GG 353178
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EXPIRES:October 6,2023
_ :"`.. Bonded Thru Notary Public Underwriters [ ] Personally Known OR [ ] Produced Identification
Type of Identification: Vc
Updated 10/17/18