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327 10th st plumb repipe If u ° , CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD j y ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Jnit PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-PLBG-1202 Job Type: PLUMBING ONLY Description: 11 FIXTURES Estimated Value: Issue Date: 5/20/2015 Expiration Date: 11/16/2015 PROPERTY ADDRESS: Address: 327 10TH ST RE Number: 170071-0000 PROPERTY OWNER: Name: BEALL, DAVID Address: 327 10TH ST GENERAL CONTRACTOR INFORMATION: Name: STEEG PLUMBING Address: 1601 MAIN ST QA JAMES STEEG Phone: - - FEES: State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Plumbing Fixtures $77.00 Trade Permit Base Fee $55.00 Total Payments: $136.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 247-5826 Fax (904)247-5845 JOBADDRESS: 3;? �1) , I!'- PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value$ 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 7— Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet 2— Hose Bibs Urinal Kitchen Sink Vacuum Breakers �\ Laundry Tray Water Connected Appliances Lavatory Z 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 ** ** SIRWD 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 4ap,41 96 r_ Phone Number Plumbing Company Office Phone Z�Q=�i v Fax City,/f L State Zip Co. Address: License Holder(Print): rJ G State Certification/Registration# Notarized Signature of License Holder fore me th'.a? ay of 2 oO•tt�. Notary Public State of Florida �F. Shiriey t.Graham S nature of Notary Public My Commission FF 086990 Expires ires 02/14/2018 ort