2308 BAREFOOT TRAC - 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-1435
Job Type: PLUMBING ONLY
Description: INSTALL 2 FIXTURES
Estimated Value:
Issue Date: 6/18/2015
Expiration Date: 12/15/2015 -
PROPERTY ADDRESS:
Address: 2308 BAREFOOT TRAC
RE Number: 169463-0600
PROPERTY OWNER:
Name: SLAGLE, WILLIAM G &ASHLEY G, *
Address: 2308 BAREFOOT TRAC
GENERAL CONTRACTOR INFORMATION:
Name: JERRY NOLAN PLUMBING INC
Address: 3115 HAMPSTED DR QA JERRY JAMES NOLAN
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $14.00
Trade Permit Base Fee $55.00
Total Payments: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITII ALL CTI'Y OF ATLANTIC BEACH ORDINANCES AM) THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: ,23 0 2 JQcrr-T'',i— /rice
PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ 23D°- °
TYPE OF FIXTURE QTY TYPE OF FIXTURE 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 FIXTURE QTY TYPE OF FIXTURE 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 **
**SIRWD 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.I hereby certify that I have read
this application and know the same 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 e . ( Phone Number 3 l k-SO k0
Plumbing Company 3""7 N.1‘..- 161,.,,6 rns 7n e Office Phone ?it`600S1 Fax CY/-2SYG
Co. Address: 3 j is t-}k,.. r- 4 J 0'. City Os So"o t((t State FL Zip 3 2
License Holder(Print): a«•, 1• (`'-1 State Certification/Registration#( F' 4S7,0
Notarized Signature of License Holder 4r
Before me this day of 20
Signature of Notary Public