118 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-854
Job Type:
PLUMBING ONLY
Description:
NEW SERVICE 10 FIXTURES
Estimated Value:
Issue Date:
4/14/2015
Expiration Date:
10/11/2015
PROPERTY ADDRESS:
Address:
118 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 $70.00
Trade Permit Base Fee $55.00
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 .2
Water Heater
Other Fixtures
Water Treating System
RE -PIPE:
TYPE oFFIXTURE QTY TYPE oFFIXTURE 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
** VRWD 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
1
Plumbing Company U /h61 IJ6
Co. Address:
License Holder (Print):
Notarized Signature of License Holder !'
Before me this ay of
Signature of Notary Public
Phone Number
Office Phone S Fax
City, &J'1 State 4 zip ?2?33
i1a)g Certification/Registration #
20