129 OCEAN GATE DR - PLUMBING I ��
rS��1. rlr1.
f'' \\ , CITY OF ATLANTIC BEACH
'" 800 SEMINOLE ROAD
) ATLANTIC BEACH, FL 32233
\ INSPECTION PHONE LINE 247-5814
,`J Flt 9'
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-1454
Job Type: PLUMBING ONLY
Description: INSTALL 10 FIXTURES
Estimated Value:
Issue Date: 6/19/2015
Expiration Date: 12/16/2015
PROPERTY ADDRESS:
Address: 129 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
Total Payments: $129.00
•
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,
0 247-5845
Ph(904)247-5826 Fax( 4)
PERMIT#l_q_a--q--_
JOB ADDRESS: % - i i '
NEW REPLACEMENT nvsTALLATION Project Value$ QTY
TYPE OF FIXTURE
QTY
TYPE OF FIXTURE 1' ✓ Septic Tank&Pit —�
Bathtub Shower —_
Clothes Washer 1= Shower Pan 1 '
Dishwasher - Slop Sink ent Sink -�T- - IC
Drinking Fountain Three Comp
Floor Drain Toilet
Floor Sink Urinal
Hose Bibs Vacuum Breakers
--- Water Connected Sink i cted Appliances _
Laundry Tray Water Heater S stem
Lavatory Water Treating y
Other Fixtures —
RE-PIPE: QTY
QTY TYPE OF FIXTURE
TYPE OF FIXTURE 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 liances
Kitchen Sink Water Connected App
Laundry Tray Water Heater
Lavatory Water Treating System ______
Other Fixtures
MISCELLANEOUS: allons(Requires 3 sets of plans)
o Sewer Replacement ❑ Back Flow Preventer o Grease Interceptor(Trap) **
❑ Lawn Sprinkler System Number of Heads
❑ Well g Department Lion.**
**SJRWD Well Completion Form. Completed form to be submitted to the Buildin De arlment for final inspec
o 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 rear
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 P(`'i9 LVQ S \ 4 3 l 1 /-1-1-- Phone Number
Plumbing Company 1 if Lit i f. ' ,• V I / A Office Phone 747-d/21-19' Fax 7L/r1'�'i /
Co. Address: ' 9 /1 iaii`Jo Rdd City/1+I 15e0 ail State R._ Zip 342,3-i
License Holder(Print): ...1 '4' /4 .: - State Certificatio : -,i ii •tion#CFC/I1.Zf 95G
Notarized Signature of License Holder _,AltAIL, - 1%--
l )r4aN PuaIC state a Florida Sworn and s' . cribed before me this 19 day of ,J(,' 1/C 20 '`'
Kim Sandberg
14,+ ,,,o Eicpresos13ono 8164874 Signature of Notary Public .,YYl.`. �G7i'L 6-Q