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CITY OF ATLANTIC BEACH
APPLICATION FOR PLUMBING PERMIT
JOB LOCATION:
OWNER OF PROPERTY: --... .
PLUMBING CONTRACTOR: .
CONTRACTOR'S ADDRESS: rj,7 I';-
Y7
STATE LICENSE NUMBER: TELEPHONE:
HOW M"Y OF THE FOLLOWING FIXTURES INSTALLED
SINKS SHOWERS
LAVATORIES WATER HEATERS
BATH TUBS DISHWASHERS
URINALS DISPOSALS
CLOSETS WASHING MACHINES
FLOOR DRAINS SHOWER PANS
OTHER
TOTAL FIXTURES: X 3.50 + $15.00
MINIMUM PERMIT FEE = $25.00
SIGNATURE OF OWNER:
SIGNATURE OF CONTRACTOR:
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INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE 1994
STANDARD PLUMBING CODE.
CALL A DAY AHEAD TO SCHEDULE INSPECTIONS — (904) 247-5826
SEWER CONNECTIONS MUST BE CALLED IN TO PUBLIC WORKS FOR INSPECTION PRIOR
TO COVERING UP — M4) nL47-5834.