114 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
]OB INFORMATION:
Job ID:
15-PLBG-1198
Job Type:
PLUMBING ONLY
Description:
10 FIXTURES
Estimated Value:
$55.00
Issue Date:
5/20/2015
Expiration Date:
11/16/2015
PROPERTY ADDRESS:
Address:
114 SUNRISE CT
RE Number:
None
GENERAL CONTRACTOR INFORMATION:
Name: ADVANTAGE PLUMBING
Address: 880 MAYPORT RD CIA GREG GAUSE
Phnnne - -
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
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: 1/f Sv r&Kt Cil PERMIT # IS--SF9% `/
NEW OR REPLACEMENT INSTALLATION:
RE -PIPE:
TYPE oFFbauRE
Bathtub
Clothes Washer
Dishwasher
Drinking Fountain
Floor Drain
Floor Sink
Hose Bibs
Kitchen Sink
Laundry Tray
Lavatory
Other Futures
TYPEoirftauRE
Bathtub
Clothes Washer
Dishwasher
Drinking Fountain
Floor Drain
Floor Sink
Hose Bibs
Kitchen Sink
Laundry Tray
Lavatory
Other Fixtures
QTY
1
QTY
Project Value $
TYPEoFFDaVRE QTY
Septic Tank & Pit
Shower
Shower Pan
Slop Sink
Three Compartment Sink
Toilet
Urinal
Vacuum Breakers
Water Connected Appliances
Water Heater
Water Treating System
TYPE oFFLYTURE
Septic Tank & Pit
Shower
Shower Pan
Slop Sink
Three Compartment Sink
Toilet
Urinal
Vacuum Breakers
Water Connected Appliances
Water Heater
Water Treating System
QTY
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 seta of plans)
❑ Lawn Sprinkler System -Number of Heads ❑ Well **
** STRWD Well Completion Form. Completed be submitted to the Building Department for final inspection."
❑ Other
Yemm becomes said if work does not momma within a six month period or work u suspended or abandoned for six months. I hereby certify thin I have reed
this application and know the same to be true and w ett All provisions of laws and ordinances governing this work will be complied with whether specified
ornot The permit does not give authority to violme the provisions ofany other suite or local law regulation mruvuction or the performance ofamsouc[ion.
Property Owners Name Phone Number
Plumbing Company %l i✓✓ ' Mr//r'Ihl/7L% Office Phone Z -4? -q 969 FaxZJ7:% �
Co. Address: Slr3 ntX?t"f �(/ City fqfj J3P/.1 Cii State Zip
License Holder (Print): / ra—
Notariwil Signature of Liceme Z
P Nmq PudkaabdFM
Kim
YSandberg
A Mr omeissZ
Fr taeellp exassOfwzata
Swoon and sdbsnbed before me this Qn day of M")\1 20Afj!
Signalise of Notary Public '