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
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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 �--�
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Notary Public of New Jersey
My commission Expires 8/6/18