The URL can be used to link to this page

566 Clippership Plumb 2015 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD j � ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 �.i Jlfl>r PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-PLBG-748 Job Type: PLUMBING ONLY Description: 1 shower pan Estimated Value: Issue Date: 3/31/2015 Expiration Date: 9/27/2015 PROPERTY ADDRESS: Address: 566 CLIPPERSHIP LN RE Number: 170703-0232 PROPERTY OWNER: Name: SHAW, MICHAEL Address: 566 CLIPPERSHIP LN GENERAL CONTRACTOR INFORMATION: Name: TERRY VEREEN PLUMBING Address: 2934 POST ST QA TERRY LEE VEREEN Phone: - - FEES: State PLMG DBPR Surcharge $2.00 Plumbing Fixtures $7.00 Trade Permit Base Fee $55.00 State PLMG DCA Surcharge $2.00 Total Payments: $66.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. rLUlvilinu rEKMIT APPLICArlTION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 247-58216 Fax (904) 247-5845 JoB ADDRESS: PERMIT# NiEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE of FIXTURE QTY TYPE of RxTURE 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 ;LE-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: i Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans) I Lawn Sprinkler System-Number of Heads :❑ Well ** * SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.* I Other :rmit 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 is 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 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 roperty Owners Name Phone Phone dumber '1 3 0 [umbing Company ~l�r�-c c �1�r�t v �. • ^ Office Phone 3M- 5 U� Fax o. Address: �� -s City StatA1. Zip icense Holder(Print): —��'� �� z�--- S e C ication/Registration# otarized Signature of License Hol Sworn and subscribed b ore e this_�_ day of_ Z 20,E iarnia�j Signature of Notary Public e�aarny rwo MWIM l-d ZZtV888£V06 buiqunld uaaaan AJ]9i et'9:90 9 6 6£aeiN