114 SANDY BCH LN PLUMBCITY 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-857
Job Type:
PLUMBING ONLY
Description:
NEW SERVICE 10 FIXTURES
Estimated Value:
Issue Date:
4/14/2015
Expiration Date:
10/11/2015
PROPERTY ADDRESS:
Address:
114 SANDY BEACH LN
RE Number:
None
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 $7.00
Trade Permit Base Fee $55.00
Plumbing Fixtures $63.00
Total Payments: $129.00
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
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS:
NEW OR REPLACEMENT INSTALLATION: Project Value $
PERMIT #
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
Clothes Washer
Dishwasher
Drinking Fountain
Floor Drain
Floor Sink
Hose Bibs
Kitchen Sink
Laundry Tray
Lavatory
Other Fixtures
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer
Septic Tank & Pit
Shower
Shower Pan
Slop Sink
Three Compartment Sink
Toilet
Urinal
Vacuum Breakers
Water Connected Appliances
Water Heater
Water Treating System
❑ 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
Plumbing Company
Co. Address:
License Holder (Print):
Notarized Signature of License
Before me this
Signature of Notary Public
of
Phone Number
_Office PhoneaY� -q Fa
City ^ State Zip ZZ
We Certification/Registration # tTT
20