1625 Atl bch Dr plumb new house �Jris1 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-1004
Job Type: PLUMBING ONLY
Description: new service 19 fixtures New home
Estimated Value:
Issue Date: 4/29/2015
Expiration Date: 10/26/2015
PROPERTY ADDRESS:
Address: 1625 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: DON HARRIS PLUMBING CO.,INC.
Address: PO BOX 14668 QA NELSON D. HARRIS
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $133.00
Trade Permit Base Fee $55.00
Total Payments: $192.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
`" PLUMBING PERMIT APPLICATION
•••p CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845 l 5-5• /�� -49
JOB ADDRESS: PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Values 10 ��•
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 3 Septic Tank& Pit
Clothes Washer I Shower '
Dishwasher I Shower Pan �—
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet :—
Hose Bibs 12, — Urinal
Kitchen Sink I Vacuum Breakers i
Laundry Tray I Water Connected Appliances I
Lavatory S 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.1 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 D
Phone Number
&u .0
Don Hams Plumbing Co., Inc. Office Ph eq �72 D�j04 Fagg ��9- 3
Plumbing Comp ny �22/o
Co. Address: A City A,CJ��nIIi I��State Zi
License Holder(Print): D �� State Certification/Registration#� 0�8
•, ; qtr Holder �G 'C�iv'f� -
commis io#FF 030749 Sworn and subsc ed b re e is day o 20�
Expires October 25,2017
BodedTNuTroyFainlnaurence800385.7019 Signature of Notary Public