296 ROYAL PALMS DR PLUMBING 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-1273
Job Type: PLUMBING ONLY
Description: sewer replacement
Estimated Value:
Issue Date: 6/1/2015
Expiration Date: 11/28/2015
PROPERTY ADDRESS:
Address: 296 ROYAL PALMS DR
RE Number: 177613-0000
PROPERTYOWNER:
Name: KLOTZ, JEFFREY DAVID
Address: P 0 BOX 330833
GENERAL CONTRACrOR INFORMATION:
Name: B & G PLUMBING, HEATING &
Address: 1729EDIBBLECIR SCOTTMARTIN
Phone:
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $7.00
Trade Permit Base Fee $55.00
Total Payments: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
06-01-15;08:38 ;Frorn:B and G Plumbing To:2475845 ;9042233750 # 1/ 1
pLuiNoING PERMIT APPLICATION
CITy OF ATLANTIC BEACH
800 SeminoJe Rd Atlantic Besucli,FL 32233
Ph(904)247-5826 Fax(904) 247-5845
fORADDRESS: 2 9 (0 �0� 'Ao
aW OR REpLACEMXNT INSTALLATION: Project Vake
TvE oF F4i7tFB9 QTY TME OF FDrrVRE 42TY
Bathtub Septic,Tank&Pit
Clothes Washer Shower.
Dishwasher Show%Pan
Drinking Fountain SlopMerk
Floor Drain Tbrocir compartment Sink
Floor Sink Toiler:
Hose Bibs Uirinal
Kitchen Sink Vactiona Breakors
Laundry Tray WOM7ConnectedApplinem
Lavatory Water:Heater
Other Fbduxas Water!Treating Syst=
RF�PIPE:
T17tE OFFDUVRE Tm,oF FvavRE _OTY
Bathtub Sopfi;Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pau
Drinking Fountain Slop Sink
Floor Drain Thron Compartment Sink —
Floor Sink Toilet
Hose Bibs urimi
Kitchen Sink Vaccauarn Breakers
Laundry Tray Water Connected Appliance$ —
Lavatory WaterHeader
Other rodures Water Treating System
MISCELLANEOUS:
XSos,orpeplaroement 0 Back Flow Preventer in Grease Interceptor(Trap) gallons(Requires 3 $ats of plans)
Ci Lamun sprinkler System-Number of Howls [3 Well
MWD Well Completion Form, ComplateaTor—mto be submitted to t&-B-u-iffm'g Department for final inspection.**
m Other
Permitlaconsues void itwork does net witkin a sixteenth Period orworkis =Uad..b.,doacd for six roceraths.
this application milknow the costs to be true and scroetclu All pmvigions;of laws Mod ordirancess governing this work will be complied with wbathcr xPlZifiLd
won The perreft does not give andicurity to Violate tbc Provision,ofsey other sine or local law=SuMon constructilm 07 the Of
Property Owners Name Phone Number
Plumbing Company Z"t-r- _0 ffic e Pho ne 2 Rj--JEe X---J WQQ�
Co. Address: -Z30 'sRDV.L4,' 5n AL,/,l City 1�7 sle & zip ��)4
4,Llicn>d(' St
License Holder (Print): State CmtMeatioaRegistration#
ni s. ROGREN om and subscribed before MwGi$ / "Ic I 20T
NOVIT No Senerclicitmid of kc;&
My C m p1ruicArnill,2016
to Mission#EE 170667 o of Notary Pablic
Bonded Through N3110118 Niclicy crucca'