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366 Royal palms dr 2014 plumb y�J�1 CITY OF ATLANTIC BEACH �J 800 SEMINOLE ROAD 77 ATLANTIC BEACH, FL 32233 PLUMBING PERMIT INSPECTION PHONE LINE 247-5814 � IF CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 14-PLBG-274 Job Type: PLUMBING ONLY Description: 1 fixture Estimated Value: Issue Date: 10/21/2014 Expiration Date: 4/19/2015 PROPERTY ADDRESS: Address: 366 ROYAL PALMS DR RE Number: 171713-0000 PROPERTY OWNER: Name: SALFER, ALLEN R. & ROSE ANN, Address: 366 ROYAL PALMS DR 366 ROYAL PALMS DR FEES: State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Plumbing Fixtures $7.00 Trade Permit Base Fee $55.00 Total Payments: $66.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 247-5826 Fax(904)247-5845 JOB ADDRESS:_ 366 dZo%L X. 32L3 PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value$_620.00_ 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 Water Heater Other Fixtures 1 Shower valve Water Treating System RE-PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE 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 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 connect. 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 Allen Salfer Phone Number 904-249-7862 Plumbing Company O' Gorman Brothers LLC DBA Bath Fitter Co. Address: 7660 Philips Highway ity Jacksonville_State FL_Zip 32256 License Holder(Print): Kevin J. O'GormanState Certification/Registration# 108280 Notarized Signature of License Holder //� Sworn and subscribed before me thiso day ofyA 20 SignatureJof Notary Public �--� qa L UddA 41 Notary Public of New Jersey My commission Expires 8/6/18