125 OCEAN GATE DR - PLUMBING •
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'iI‘ CITY OF ATLANTIC BEACH
3,1 800 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-1455
Job Type: PLUMBING ONLY
Description: INSTALL 10 FIXTURES
Estimated Value:
Issue Date: 6/19/2015
Expiration Date: 12/16/2015
PROPERTY ADDRESS:
Address: 125 OCEAN GATE DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: ADVANTAGE PLUMBING
Address: 880 MAYPORT RD QA GREG GAUSE
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $70.00
Trade Permit Base Fee $55.00
I
Total Payments: $129.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 # S
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JOB ADDRESS:
PLACEMENTNST�,LATION: Project Value$ Q
NEW OR RE I
QTY TYPE OF FIXTURE
TYPE OF FIxTU ', Septic Tank&Pit Bathtub ` ,� Shower I
Clothes Washer Shower Pan
Dishwasher ----- Slop Sink ent Sink — --
Drinking Fountain Three Compartm
Floor Drain — Toilet
Floor Sink Urinal --
Hose Bibs Vacuum Breakers
Kitchen Sink Water Connected Appliances —- i Laundry Tray Water Heater System
Lavatory ---- Water Treating ----
Other Fixtures ----
RE-PIPE: TYPE OF FIXTURE Qom' —
TYPE OF FIXTURE QTY
Septic Tank&Pit Bathtub Shower --
Clothes Washer — Shower Pan
Dishwasher — Slop Sink ----
Drinking Fountain Three Compartment Sink .---
Floor Drain Toilet
Floor Sink Urinal ---
Hose Bibs Vacuum Breakers Appliances Kitchen Sink Water Connected App
Laundry Tray Water Heater
Lavatory Water Treating System —
Other Fixtures
MISCELLANEOUS: allons(Requires 3 sets of plans)
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) ** S
❑ 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.I hereby certify that I have real
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 l V ej 6 F\P S N e 3 i J n.f Phone Number �,�
Plumbing Company 1 t of All f_ f ' I a 41 '14 Office Phone,'Z.47-% gig Fax.2�7'c %1
7 , !Dori-Pct City fin 15Pa pit State �✓� Zip,?z -i
Co. Address: ��Q � (�1,J
License Holder(Print): _ !4 /, State Certificatio t - 41. :tion#CFC/Nz�95q
Notarized Signature of License Holder __,...f. .�- " ,=
4,4910 l Notary aualc state a Florida Sworn and s' . cribed before me this I 1 day of .- 1 U N e 20 is
Kim Sandberg
‘0," Ex tees 09130!2018 164674 Signature of Notary Public n'-v, SG7 `.4(6-2