110 SUNRISE CT PLUMBINGCITY 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-1197
Job Type:
PLUMBING ONLY
Description:
10 FIXTURES
Estimated Value:
$55.00
Issue Date:
5/20/2015
Expiration Date:
11/16/2015
PROPERTY ADDRESS:
Address:
110 SUNRISE CT
RE Number:
None
GENERAL CONTRACTOR INFORMATION:
Name: ADVANTAGE PLUMBING
Address: 880 MAYPORT RD CIA GREG GAUSE
Ph...... -
FEES:
State PLMG DBPR Surcharge
$2.00
State PLMG DCA Surcharge
$2.00
Plumbing Fixtures
$70.00
Trade Permit Base Fee
$55.00
Total Payments: $129.00
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
Soo Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
IOBADDRESS: /%D-S�oJR15t= C� PERMIT# IE• SA�l -/a7Y
,NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPEOFFDrTURE QTY TYPEoFFIXTURE QTY
Bathtub
l
Septic Tank & Pit
Clothes Washer
Shower
Dishwasher
Shower Pan —
Drinking Fountain
Floor Drain
Slop Sink
Three Compartment Sink
Floor Sink
Toilet
Hose Bibs
Urina�
T
Kitchen Sink
Vacuum Breakers
Veen
Laundry Tray
Water Connected Appliances I
Lavatory
Water Heater
Other Fixtures
Water Treating System —
RE -PIPE:
TYPE oFFnavRE
QTY
TYPE oFFIXTURE 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 seta of plans)
❑ Lawn Sprinkler System -Number of Heads ❑ Well **
** &fRWD Well Completion Form. Completed form to be submitted toeth B g Department for final inspection.**
Permit becomes void if work does not commence enmm am menta Ps'—
this application and know the some to be true and cored 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 my other state or local law regulation construction or the performance ofcoosnuctim.
Property Owners Name m E Phone Number
Plumbing Company (2/-/ Office Phone 7117-C2YS Paxy�
fqR 8p/w/l State � Zip ,-y�
Co. Address: ��n n%/J� rL,12"`� 1%r� City —
License Holder (Print): ar24 C4a L°g ` , -State Cerhfi strntion # /�12.�i9.59
Notarized Signature of License Holder
Katar msme arFbnm Swom ands' ✓ 'bed before me this � day of i'M ") -\) 20�-
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Ary CanmLkm FF 1819]} Signature of Notary Public
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