1945 Seminole Rd 2014 plbg , CITY OF ATLANTIC BEACH
l 800 SEMINOLE ROAD
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: 4- -
Job Type: PLUMBING ONLY
Description: REPIPE 12 FIXTURES
Estimated Value:
Issue Date: 11/14/2014
Expiration Date: 5/13/2015
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: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Nlar 08 10 12:54p Infot7rabon System,sCfTy 0 904-247-5845 p,1
PL NG PERAUT APPLICATION
CITE' OF ATLA-T c BEACH
$00 Seminole Ptd Atlantic Beach,FL 32233
Ph(904) 247-5526 Fax(904)247-5845
,ADB ADDRESS: 1 J cJP•�'11 V1�'� �� � #
NEW CSR 'LAv�NT 1NS'I'r-LLAT11()Na Project ValUe $
TYPE o--F a r xE (QTY TYPE OF F-OfTU E OTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
-Dishwasher mover pan
L;inking Fountain Slop.Sin's
Floor Drain Three Compartment Sink
To
Floor Sink me
Urinal
ina
Hose Bibs
Kitchen S�� Vacuum Brzals�:s
c:s
Laundry Trak Water Connected Applian
Nater Heater
pther'F�iatures Rater Trtrat3rig System
RF,-PIPIT o
7 o-FLEruizE OTY
Bathtub �2 Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
DrinldFoaryin _ Shop Sink
Floor Drain -_ _. Three Compartment Sink
Toilct 3
Floor Sink - -
Hose Bibs
Kitchen Sir' Va�uBreakera
mdry T may_ Waver Connected Appliances
Lat
Lavatory Vater Heater — -
p��F 7TTes Water Treatiaa System
!�,USCELLA TEOUS: ons u z�3 5ei5 0# pa d
❑ Sewer Replacement C3 Back Flo-W Preventcr ❑ Crease Interceptor(Trap) g� (Ra�
❑ WeE T
❑ Latir-r> Sprsnlcler System—7=ber of Heads � e Depar fr��
Cartpleti�,:Fom. Completed fo n to be submitted to t e Buildi� p" 1
❑ Other. _.
?errnii a sax month period or work is saspendemo
d or abandoned for six nths.I hereby c`rt�y that I have rmd
becomes raid if work does net commence�rithin
this anplicadon and know t,`se same to be true Emd cosec. A71 previsions of tours and ni:Ta-,ces gpva ring this�or�will to complied with whether specified
or not- The permit does not give authority to vioda3.c the provisions of any-othrs state or local lav+reguiatian cnusnvctton or the performance construcson.
Name 1 J Inn ►�nl l (�,�}�CJ�' \ Phone N=ber e2 We -33I
Property Owners � i,�
Fi=biz.g Company
�i
K] j,
Plumbing, Inc. Oar.==Phone �'�I.7��� Fax.i%�-���
385U l ,)rpomi;-e 'Zi are uourt, State Zip
C-0. Address:
City
License rise Holder(Frint); ����� �;�� State CertifcationfRegistrV-]Lon
1' otarized,Signature of License Holder
S-WOM and subs=ibed before me this Z day of 8'Y�a�w�R1' 20
Signage of Notary Public '� � Q 0
o�yrNotary Public State of Florida
? L.a8heica Wilson
My Commission EEOW523
r ��orr�b Expir�s.O110U20t5