1618 Beach Ave plumb 2014 f , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
PLUMBING PERMIT INSPECTION PHONE LINE 247-5814
ALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
)OB INFORMA
Jot) - -
Job Type: PLUMBING ONLY
Description: 24 fixtures new and repipe
Estimated Value:
Issue Date: 10/8/2014
Expiration Date: 4/6/2015
PROPERTY ADDRESS:
Address: 1618 BEACH AVE
RE Number: 169547-0000
PROPERTY OWNER:
Name: MCKNIGHT, MARY JANE
Address: C/O 1959 SELVA MARINA DRIVE BRUCE ROBBINS
GENERAL CONTRACTOR INFORMATION:
Name: PROFESSIONAL PLUMBING SERVICES
Address:
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Plumbing Fixtures $147.00
Total Payments: $206.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax(904) 247-5845
.TOB ADDRESS' /6--d /' PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFIXTURE QTY TYPE oFFIXTURE 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 Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System I
RE-PIPE:
TYPE oFFIXTURE QTY TYPE oFFIXTURE 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 2
Laundry Tray / Water Connected Appliances
Lavatory 4. Water Heater
Other Fixtures Water Treating System .may
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
**SJR WD 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 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.
Property Owners Name Phone Number
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Co. Address: T
License Holder(Print): _�r�L/!ten ,Q PM 4 , State Certification/Registration# C'�CrJ3
Notarized Signature of License Holder
Before me this day of 20
Signature of Notary Public