2235 BEACHCOMBER TR PLUMBING �T
CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEItT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-1278
Job Type: PLUMBING ONLY
Description: 6 FIXTURES
Estimated Value:
Issue Date: 6/1/2015
Expiration Date: 11/28/2015
PROPERTY ADDRESS:
Address: 2235 BEACHCOMBER TR
RE Number: 169463-0168
PROPERTY OWNER:
Name: COX, MELVIN L
Address: 2235 BEACHCOMBER TR
GENERAL CONTRACTOR INFORMATION:
Name: BILL FENWICK PLUMBING
Address: 11623 E COLUMBIA PARK DR CIA WILLIAM K. FENWICK, JR
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $42.00
Trade Permit Base Fee $55.00
Total Payments: $101.00
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
JoB ADDREss: 2-IS5 r I Yll.t I PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$1$00,O6
TYPEOFFIXTURE QTY TYPEOFFixTuRE 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 F/XTURE QTY TYPEOFFixTURE 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
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.1 hereby certify that 1 have read
this application and know the some 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 M P\ Oby Phone Number(01 to`Z-' ` M
Plumbing Company ?!n),\ ie,, )k_k -kA, b, Office`Phone-] X02 Fax ZLI'BBIoG
Co. Address: Wdi L3 W ynb'tO, pr, y k- 'bf t City \le State d Zip 3225,4"
License Holder(Print): 1AN11i rn l k, State Certification/Registration#Mr+40039
Notarized Signature oJLicense Holder
RSworn and sub 'b hefo e is day of u� 20
aoMry PaaYe SMM d RaMF
Susan T awtan Signature of Not Public ->
MY Caxowyan FF 196022
Exp saNMa01B