106 SANDY BCH LN PLBG 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-853
Job Type: PLUMBING ONLY
Description: INSTALL 10 FIXTURES
Estimated Value:
Issue Date: 4/14/2015
Expiration Date: 10/11/2015
PROPERTY ADDRESS:
Address: 106 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: $129.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904) 247-5826 Fax(904) 247-5845
3oB ADDRESS: PERMIT#)
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFIXTURE QTY TYPE OF FIXTURE• �1TY
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 TrayWater Connected Appliances
— Water Heater
Lavatory
Other Fixtures Water Treating System l
ISE-PIPE: �J
®TY
TYPE oFFIXTURE OTY TYPE oFFIXTURE
Bathtub Septic Tank&Pit
Shower
Clothes Washer
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Three Compartment Sink
Floor Drain
Toilet
Floor Sink
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS: gallons(Requires 3 sets of plans)
❑ Sewer Replacement Ei Back Flow Preventer ❑, Grease Interceptor(Trap)
C Lawn Sprinkler System Number of Heads
Well
SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.*
Other
that I have read
Permit becomes void if work does not commence or�rmt Ali provisions of iaw and ordmonth period or work is inances
sdgov ming this s work will be complied with wor abandoned for six months.I herel)y hether specified
this application and kno«the same to be true
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.
Phone Number
Property Owners Name A ,7. 99 Fm
. �/ l
Plumbing Company
1t n �•�.-�r i_ �t / Office Phone
City r t3 State a Zip 2� 3
Co. Address:
S Certification/Registration#
License Bolder(Pram):
Notarized.Signature of License H01der � 20 /�
Sworn and subscribed efore me s day of /�
far Notary Public Stale of Florida
Kim SanderSi atuTe of Notary Publi
A My Commh ion FF 16074
�i Expkw 0913012015