30 17TH sT 2015 pLUMB 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-S814
JOB INFORMATION:
Job ID: 15-PLBG-1015
Job Type: PLUMBING ONLY
Description: 3 fixtures
Estimated Value:
Issue Date: 4/29/2015
Expiration Date: 10/26/2015
PROPERTY ADDRESS:
Address: 30 17TH ST
RE Number: 169590-0000
PROPERTY OWNER:
Name: DOWLIN, DIANE M & WILLIAM A,
Address: 30 17TH ST
GENERAL CONTRACTOR INFORMATION:
Name: STEVE REESE PLUMBING
Address: P 0 BOX 26397 JKVL FL 32226
Phone:
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $21.00
Trade Permit Base Fee $55.00
Total Payments: $80.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
(904)_Z�-5826 Fax (904) 247-5845
JOBADDRESS: 1262 —PERMIT#
# I I
NEW OR REPLACEMENT INSTALLATION: Project Value$
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:
o Sewer Replacement o Back Flow Preventer o Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Ei Lawn Sprinkler System-Number of Heads o Well
SJRWD Well Completion Form. Completeil-form to be submri�tted to the Department for final inspection."
Ei 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 thAtisions of any other state or local law regulation construction or the performance of construction.
Phone Number 24PI
Property Owners Name R___t4l 01/
Plumbing Compan 1��5 eeD i'y Office Phone 1'7 4--'/o Fax—
Co. Address: '397 city x Statenzzip 32=-%Zki
License Holder(P State CertificationlRegistration
W(P
Notarized Signature of License Holder
eyokil, Notary Public State of Florida Before me this ay o 20
Shirley L Graham
"Y commission FF 086990 gnature of Notary Pu
Expires 02/14/2018 �hio Ity