2020 Vela Norte 2014 Sewer CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
!� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMATION:
Job ID: 15-PLBG-31
Job Type: PLUMBING ONLY
Description: SEWER REPLACEMENT
Estimated Value:
Issue Date: 1/9/2015
Expiration Date: 7/8/2015
PROPERTY ADDRESS:
Address: 2020 VELA NORTE CIR
RE Number: 169506-1044
PROPERTY OWNER:
Name: BREWER, TIMOTHY D
Address: 2020 VELA NORTE CIR
GENERAL CONTRACTOR INFORMATION:
Name: LARRY TEAGUE & SONS PLUMBING
Address: 203 OCEANFRONT QA ARNOLD GEORGE BENNETT
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: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845
.TOB ADDRESS: p,�C, L `Q PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
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
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
M ELLANEOUS:
Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well
** VR WD 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 TO M t O�J Phone Number 3S�I - '7`4`f �S�O
Plumbing Company F1G -`f C'A(-,U[ c� S 0 tJ 6, Office Phone x"10 -2,2�3�l Fax 1i G!- 2_1e�
Co. Address: a 1_� QQP_a4C oc) City Neo State C-J _Zip 3_-1214p
License Holder(Print): CZ-1�U� o nt1e q� State Certification/Registration#� Q 1 S2c(
Notarized Signature of License Holder s- -a'e 1C ff -
Sworn and subscribed before me this day of JMAJ"o-V 20
IIElI►NIE A.oARL1NG7 gnature of Notary PublicAAAA4
M1'GOMMISUM#EE198YU
EXPIRES Msy 15.2016
(�07)�JM-0/M