266 CAMELIA ST PLUMBING CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J 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-1203
Job Type: PLUMBING ONLY
Description: INSTALL 12 FIXTURES
Estimated Value:
Issue Date: 5/20/2015
Expiration Date: 11/16/2015
PROPERTY ADDRESS:
Address: 266 CAMELIA ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: CANNON PLUMBING, INC.
Address: 1794-1002 ROGERO RD QA OLIN MARSHALL CANNON
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $84.00
Trade Permit Base Fee $55.00
Total Payments: $143.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
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//"1���. /� � Ph(904)2475826 Fax (904)247-5845
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NEW OR REPLACEMENT INSTALLATION: Project Value$ t.Jpp _
TYPEOFFIXTORE QTY TYPEOFF7XTORE QTY
Bathtub , Septic Tank&Pit
Clothes Washer Shower
Dishwasher IShower 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:
TYPEOFFIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit 1\
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.I hereby certify that I have read
this application and know the same to be true and correct All provisions of laws and ordinances goveming this work will be complied with whether specified
or not. The permit does not give authority to violate the provisions of any other stale or local law regulation construction or the performance of construction.
Property Owners NameCOCA--)Phone Number COCA
Plumbing Company Cca,' If3N ' n �Im Office Phone 00AD-1441- ax(gclik-�5'S\-cYVW
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Licep3� F p13: ✓tti 41541n0-) State Certification/Registration#
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NodEed Srgricense Holder �—
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Sworn and subscribed before this
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%•�s .`:d.......... Signature of Notary PublicZo aJ%le�G