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2060 Beach Ave 2014 Plumb r SS CITY OF ATLANTIC BEACH s� 800 SEMINOLE ROAD JroATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 14-PLBG-631 Job Type: PLUMBING ONLY Description: INSTALL 17 FIXTURES Estimated Value: Issue Date: 12/11/2014 Expiration Date: 6/9/2015 PROPERTY ADDRESS: Address: 2060 BEACH AVE RE Number: 169713-0020 PROPERTY OWNER: Name: ZAHL, JAMES F Address: 2060 BEACH GENERAL CONTRACTOR INFORMATION: Name: EAGERTON PLUMBING CO. Address: 1093 N MCDUFF QA NONE SEE NOTE Phone• - - FEES: State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Plumbing Fixtures $119.00 Trade Permit Base Fee $55.00 Total Payments: $178.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Bead'h,FL 32233 Ph(904)247-5826 Fax(904)247-5845 JOB ADDRESS: Q i�Cl Li 1 1�U� PERMTr# NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank&Pit Clothes Washer _ _ Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Dram 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 Dram Three Compartment Sink Floor Sink Toilet Hose Bibs �- Urinal _L_ Vacuum Breakers Kitchen Sink Laundry Tray Water Connected Appliances Lavatory Water Heater - ---- Other Fixtures Water Treating System MISCELLANEOUS: gallons(Requires 3 sets of plans) ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) g ❑ Lawn Sprinkler System Number of Heads ❑ Well ** **SJR 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 t f Jam,7 ('IQsSeF Phone Number `��"�z 7- 14's 114's e/70 c Office Phone 3 52f o 7d / Fax Plumbing Company 4 Co. Address: �0a g N /I? Dlllf fvf City �A State /LZip 3?ZS License Holder(Print): -' x State Certification/Registration#�`FC/�fZY AlMfdLHolder L 80, •BRANDI L.HOLM11 1-' -, Sworn and subscribed before a this / day of 20 Notary Public-State of Fiur7Ud j,=My Comm.Expires Jun 20.201 Commission N FF 100744 Signature of Notary Public "'•',;;os�� ;:•'