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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�- +n Kin Ary CanmLkm FF 1819]} Signature of Notary Public a7 awaaa amur:ore