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1915 Sea Oats dr 2014 Plumb CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 ]OB INFORMATION: Job ID: 14-PLBG-723 Job Type: PLUMBING ONLY Description: 2 FIXTURES Estimated Value: Issue Date: 12/31/2014 Expiration Date: 6/29/2015 PROPERTY ADDRESS: Address: 1915 SEA OATS DR RE Number: 172020-0914 PROPERTY OWNER: Name: WALLACE, PATRICIA A Address: 1702 N 3RD AVE 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 Trade Permit Base Fee $55.00 Plumbing Fixtures $14.00 Total Payments: $73.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Mar 03 10 12:54p Information SystemsCfTY 0 904-247-5845 p.1 PLUMBING PFJ TAUT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Be"FL 32233 Ph(904) 247-5826 Fax(904)247-5545 JoB ADDRWESs• T� `�A � 3�9 3 5 PExmrr 3r OR REPLACEMENT INSTALLAT110N: Project Value $ TYPE o.i-FIXTGe3E ©TY 7'YPi OFF�xTURE QTY Bathtub Septic Tants&Pit Clothes Washer Shower -Dishwasher Shower pwl DrinkingFountain SlopSink Floor DrainThree Compartment Sink Floor Sink Toilet �— Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray water Connected Appliances Lavatory' Nater Heater -C9erFfxiures Water Treating System %,-PIP +p 7`r-FE of FIX7 fid QTY T'YFE or FLUVRE QTY Dathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan inQnQFocwtain .._ SlopSink Floor I - Thr Compartment Sink Floor Sink Toilet Ilse Bibs U,-tnai Kitchen Sink VaouurnBreak= Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System i'IISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Presenter ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of p12;ss) ❑ Law-,n Sprinkler System 1-7umber of Beads ❑ wed SIRTVD X211 Campletio,�t Form. Completed form too be submitted to the Building Department for �l inspection.** Lo Other. Permit becomes void if work does not commence wsuspended within a six month period or work is or abandoned for six months.I hereby c.rtrfv that I have read 'bis application and know the same to be true and correct. All provisions of laws and ordinances govmnmg this wailk will be complied with whether spe^ified or nct- The pear it does hot give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. s roxrty Owners Name e— Phone Number Flumbing Company David G av PIt'ntibing, Inc. Office Phone � 7�-��'J Fax-7 -� U C- rprirgite Shu-are ourl a. Address: City State Zip isv�ase 1$o�,dsa(Print): ..1��. `� ertification/Registration.0 � /' 07-2j Notarized Signature of Lace,We 1VIkT Swom and subscribedre rhe this:X11'day of QJ� 20 J``L Signature of Notary Public rj-rCNcp- �ear'6�G Notary Public State of Florida LaSheica Wilson t? My commission EE050523 .J �Boa Expires 01/0412015