627 Selva lakes Cir 2014 Plumb •i�r�J��j
ir Ju'
� CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
,j r ATLANTIC BEACH, FL 32233
PLUMBING PERMIT INSPECTION PHONE LINE 247-5814
CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 14-PLBG-425
Job Type: PLUMBING ONLY
Description: REPIPE 12 FIXTURES
Estimated Value:
Issue Date: 11/14/2014
Expiration Date: 5/13/2015
PROPERTY ADDRESS:
Address: 627 SELVA LAKES CIR
RE Number: 172027-5556
PROPERTY OWNER:
Name: MCDONALD, THOMAS J
Address: 627 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: DAVID GRAY PLUMBING INC.
Address: 6491 S POWERS AVE QA DAVID FRED GRAY
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $84.00
Trade Permit Base Fee $55.00
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Niar 08 10 12:54p
Info=.bon Syr.temsCflY 0 904-247-5845 P•1
P11 T_ �� lT APPLICATION
C][TY OF AT LANTic BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5526 Fax(904)247-5845
JOE ADDRESS- ��� OSl�v�S d , PERM
NEW OR REPLAC NT INSJFAj.,LA'I"ION Project Value $
TYPE of Fr-.ru ZE DT'
Bathtub Septic Tank&Pit
Shower
Clothes Washer
Dishwasher Shower ink
„ king Fountain Situ
Drain Three Cmpart>nea# Sin's
Floor .
Toilet
Floor Sims. Urinal
Hose Hies Vacuum Breakmzs
Kitchen Sik Water Connected Appliana:.s
Laundry Try water Heater
La^vztl 1Water Treating System
-Other'Fb bras
QTY
TYPE tan a fl
7 -F Dr�'� QTY
_ Septic Tank&Pit
Bathtub
Shower
Clothes usher __L_
— Shower Pan
Dishwasher
Slop 5irlc
Drinking Foarl,"n = Thr Compartment Sink
Floor riain Toile - --
Floor Sink �_ Ural
Hose Bills VacuumBre.n
Kitchen Sim —�— V, ater Connected Appliances
Laundry T rEy _ water Heater
Lavatory Nater Treating System 1
Other Fi:tures
MISCELLANEOUS: 1 ons z uses 3 sets of P12
❑ Sewer Replacernen. ❑ Back Floes'Preventcr ❑ Grease Lnierc-�tor(Trap) (� �
❑ Law-n Spj6 k er 5ysiem-- uiber of�3eads T
&arP;D �2ZZ CarTpletio;-Form. Completed form to be submitted to t e Building Depastrneut for;mal rection.=}
o Other.
^et ut becomes void if wodoes not caence wiihin a Si-- period eriod or won't is saspended or abandoned for s�months I hereby ter that I have rend
t'
r: tnm
this application and know 41=same to be tue and erre A71 previsions of laws and ar•di rmces govaming this-smez wi3l l-complied with whether speeifis3
cr not the permit does art give authority to violatt the provisions o€arty other stat:.or local lmv reg,ladon cons= or the Fxrformrn�c/e of construcsoQn•
C Phone Nt�ber
Pr^7erty Owners Name L► l 1(�l (C- � �,
S'� Gray f '; 131 g J Inc. Offil-Phone
Pl=bing Company s >� Far.i y
(, sv885 4Otl State
zip
city
L)• .�1 +� , Y State CertiEcationlRenistration
L.isense FrolerC
I'VoItr'4-e-4 Srp-atzare of License$oiler
S-rom and subsc'i�d before me this day of OY.�XY11'�1Q� 20
Signa►=e ofNotary P-ablic
ro
WP Notary Public State of Florida
LaSheica Wilson
My Commission OF VV Expires 01 0412015050523