341 Sargo rd 2014 repipe CITY OF ATLANTIC BEACH
f. y 800 SEMINOLE ROAD
s) ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
yJi3 �.
14-00000033 Date 1/13/14
Application Number - - . 341 SARGO RD
Property Address . . . . .
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . 0
---------------------------
Application desc
8 fixtures
--------------------------
Contractor
Owner
-------------------
FORE, STUART ASHBY ADVANTAGE PLUMBING
1616 BEACH AVE P O BOX 49225
ATLANTIC BEACH FL 32233 JACKSONVILLE BEACH FL 32240
(904) 247-9848
----------
-----Permit
. PLUMBING PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee . . . . 111 . 00 0
Valuation .
Issue Date . • ' ' 7/12/14
Expiration Date
2 . 00
Other Fees
STATE PLBG DCA SURCHARGE
STATE PLBG DBPR SURCHARGE 2 . 00
---------------------------------------Paid------Credited
Due
Fee summary Charged
Permit Fee Total 111 . 00 111 . 00 . 00
. 00
. 00 . 00 . 00
Plan Check Total 4 . 00 . 00 . 00
Other Fee Total 4 . 00 00 . 00
Grand Total 115 . 00 115 . 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 211
JOB ADDRESS: 4nm PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower 1
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory .2 Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FMTURE QTY TYPE OF FIXTURE QT'S'
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 Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement E:1 Back Flow Preventer El Grease Interceptor (Trap) gallons(Requires 3 sets of p )
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
r.
**SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspectio
❑ Other
ad
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
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 speci
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 constructi
Property Owners Name,�/ �A�S�.�[ n Phone Number
Plumbing Company /KYVi�u/A�Q P �I Z CIO
�i OfFice Phone�'�� Fax `l
Co. Address: RC) / U City State Zip
1-
License Holder(Print): tate Certification/Registration# C L`
Notarized Signature of License Holder
Swornand subs befor me s a of 20
Signature of Notary Public