1945 Seminole Rd 2014 plumb CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 14-PLBG-499
Job Type: PLUMBING ONLY
Description: 12 fixtures
Estimated Value:
Issue Date: 11/24/2014
Expiration Date: 5/23/2015
PROPERTY ADDRESS:
Address: 1945 SEMINOLE RD
RE Number: 169542-0518
PROPERTY OWNER:
Name: MARCH, DOMINIC G
Address: 1945 SEMINOLE RD
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: $143.00
I
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Mar 08 10 12:54p Information SystemsCFFY 0 904247-5845 p.1
PLUTM13I G PFRNU ' APPLICATION
CITY OF ATLANTic BEACH
800 Seminole Rd Atlantic Bea:h, FL 32233
Ph(904) 2477-525 Fax(904) 247-5545
JoB ADDRESS'
�W OR REPLACEMENT INS` A-L ATION: Project Value �
TYPE o_i-F wH OTY 7'yp.E o.7 F r-TuBE OTY
Bathtub Septic Tank&Pit
Clothes Washor Shower
Dishwasher Sir Pan
1 inking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sin: Toilet
Hose Bios Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Nater Connected Applia?cts
Lavatory Water Heater
10-therFixtures Water Treating System
PE-PUEo
Dathtub _'Z Septic Tank&Pit
Clothes Washer Shower
Dishwasher I Shower Pan
DrinldnLa Fonntain Slop Sink
Floor Drain Thre; Compartment Sino
Floor Sink Toil-
Hose Bibs �_ Urinai
Kitchen Sink �_ Vacuum Breaker
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS
❑ Sewer replacement ❑ Balk Flow Prover-ter ❑ Grease hiterc..ptor(Trap) gallons(Requara 3 sets of paw)
❑ Lawes Sp—Ainkler System--`lumber of Heads ❑ Well *r
SJR,WD F211 Campletzon Form. Completed form to be, submitted to the Building Departrr_ent fur �1 inspection.'1
❑ Other. .
.Form±t be-comes void if we&,does net commence wilhm a say month period or work is suspended or abandoned for six months_I hereby certify that I have rezd
this application and]know `�e sto
same to be tae and correct. A-11 provisions of laws and ordinances governmg Lbis wvr:will be complied with whether specifi--d
or nct- The pc=t does not give authority,to violate the pro-vis' of any other state or local Ixv regulation constriction or the perform-Anne of construction.
Pro-pe iy Oyaners NaFne _ j jsj IYl y1�pgCy�,gpy bin
C11e�p(n� Phonc Ni=ber OS`1- QJ' G� —
Flumbing Company �� O;fce Phone �'�I 7�-' � Fay.i
Co. Address:
dress: 0855 { try 3a`i�;;.._�`,75-a€•c t,ourt,
City State lip
1.E;L
License HoRder(I rint), v :'i J Y State ertificatianlRe r n-9
g1Sti'a10 C � �
1'rT ti�P�Z�2'S Qs�g are
of License Hoide7 ,, ,(
Sworn and subscril�d before me this�ffday o" r\)Cmp� 20 1
Signatiire of Notary Public
roar^oe4� No=Wilson
Florida
N , LaMy0523Ex