665 Sailfish Dr 2014 Sewer CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 14-PLBG-718
Job Type: PLUMBING ONLY
Description: SEWER REPLACEMENT
Estimated Value:
Issue Date: 12/31/2014
Expiration Date: 6/29/2015
PROPERTY ADDRESS:
Address: 665 SAILFISH DR
RE Number: 171225-0000
PROPERTY OWNER:
Name: GHIOTTO,PHILIP M & ELIZABETH B,
Address: 1528 PARK TER
GENERAL CONTRACTOR INFORMATION:
Name: KIMBALL PLUMBING, INC.
Address: 12024 SUNOWA SPRINGS TR QA MARK EDWARD KIMBALL
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $7.00
Trade Permit Base Fee $55.00
Total Payments: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
L�Ph (904) 247-5826 Fax (904) 247-5845
TOB ADDRESS: (QJ5 ./ (A'I f 5(' D✓i V (. PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ wo
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
RE-PIPE:
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
MISCELLANEOUS:
Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well
** SJRWD 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 giv a hority`to violate the rovisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name ,1 1 C l�t V1+0 Phone Number
SSS 'I$4P• 7;3S
Plumbing Company�,Y1lbacll �l l�lo '✓tS, Office Phoneq99- Fax
Co. Address: O 3�0 AA C'C"k � . CitRJCLr SOZ✓1 Il f State ff Zip 3 s
License Holder(Print): I'1itI0C( I ( to Certification/Registration hat" 6'579' 7
Notarized Signature of License Holder
TINA E.JONES-LEFEVER Before me this day of 20
Notary Public,State of Florida
My Comm.Expires May 18,2016 Signature of Notary Public
Commission No.EE 193027