750 SABALO DR PLUMBING ml CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
r it r
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-532
Job Type: PLUMBING ONLY
Description: REPIPE 15 FIXTURES
Estimated Value:
Issue Date: 3/10/2015
Expiration Date: 9/6/2015
PROPERTY ADDRESS:
Address: 750 SABALO DR
RE Number: 171456-0000
PROPERTY OWNER:
Name: FEDERAL NATIONAL MGT ASSOC
Address: P O BOX 650043
GENERAL CONTRACTOR INFORMATION:
Name: STYLES SMITH PLUMBING, INC
Address: 1537 PENMAN RD SUITE A OA DARRELL GLEN SMITH
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $105.00
Trade Permit Base Fee $55.00
Total Payments: $164.00
PERM1HT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BDILDV iG CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904) 247-5826 Fax (904)247-5845
JOB ADDRESS:_71—,q_o Y.d/w Q,�• PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE of FIXTURE QTY TYPE oFFixTuRE QTY
Bathtub AL 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:
TYPEoFF/XTURE QTY TYPE of FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher r Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet R
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray T Water Connected Appliances
Lavatory r 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 **
**STRWD 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 Y,, {`,4f' A,/op�( Phone Number
Plumbing Company. r4/..r 5'. , %4 I /2s. .ro c• Office Phone Fax
Co. Address: Zf.?7 Z) ,ww— '4iZ City .T gila State F/. Zip zAAro
License Holder(Print): C <..,t* State Certification/Registration# C.Ct a vi "I
Notarized Signature of License!folder
Before me this day of 20
Signature of Notary Public