440 OCEAN BLVD PLBG :.S rLyr
CITY OF ATLANTIC BEACH
1 S 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
Sob ID: 14-PLBG-630
Sob Type: PLUMBING ONLY
Description: 3 FIXTURES
Estimated Value:
Issue Date: 12/11/2014
Expiration Date: 6/9/2015
PROPERTY ADDRESS:
Address: 440 OCEAN BLVD
RE Number: 170171-0000
PROPERTY OWNER:
Name: SNYDER, SCOTT
Address: 440 OCEAN BLVD
GENERAL CONTRACTOR INFORMATION:
Name: COGBURN AND WAKEFIELD PLBG
Address: 5900 TOWNSEND BLVD APT 522 QA JOHN COGBURN
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $21.00
Trade Permit Base Fee $55.00
Total Payments: $80.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826rr Fax (904) 247-5845
JOB ADDRESS: '4 q t 0�e.Atis R(yo PERMIT# *ADD-ch
NEW OR REPLACEMENT INSTALLATION: Project Value$
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
i
RE-PIPE:
TYPE oFFIXTURE QTY TYPE oFFIXTuRE 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�prinkler System-Number of Heads ❑ Well
**SJRW 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 correct. 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 Ga w,l dl 0^ hone Number 3 LO
Plumbing Company (;o to RN +- fig" ice Phone 1701-5-2-"7-/Z?oFax QoY 3 71__q 631
Co. Address: 6;0'7 'r ,+4 t-j,e W 5� City -rA X State FL Zip 3 2 2-1 o
License Holder(Print): o�nn bvA-' State Certification/Registration# CF- 14 BIYO
Notarized Signature of License Holder 4:�� fzt_'�� -
Before me this d 20
Signature of otary Public