383 Plaza 2014 plumb �t
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
JOB INFORMATION:
Job ID: 15-PLBG-32
Job Type: PLUMBING ONLY
Description: INSTALL 6 FIXTURES
Estimated Value:
Issue Date: 1/9/2015
Expiration Date: 7/8/2015
PROPERTY ADDRESS:
Address: 383 Plaza
RE Number: 170020-0000
PROPERTY OWNER:
Name: OBRIEN, CHRIS R
Address: 383 PLAZA
GENERAL CONTRACTOR INFORMATION:
Name: ADVANTAGE PLUMBING
Address: 880 MAYPORT RD QA GREG GAUSE
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $42.00
Trade Permit Base Fee $55.00
Total Payments: $101.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION (15r
CITY OF ATLANTIC BEACH ry
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904) 247-5845
JOB ADDRESS: � �j I gS P[1) Z q PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
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
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 give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name Phone Number
Plumbing Company,210 61` ANMa/T/6 Office Phone,4177
Co.Address: g� /A/ �� �_)Qd City ___�c�l State�Zip�D 33
License Holder(Print): - C 4,aS State Certifi �*n/Registration# 6cej q--116YT q
Notarized Signature of License Holder
Sworn and subscriore me s�_day ofsubscribed20
JULIE YOUNG CHRISTY
MY COMMISSION#FF005505 Signature of Not Public
EXPIRES:Jury 21,2017 gn '
Bonded Tluu Notary Pudic UndeirritersLJ