117 OCEAN GATE DR - PLUMBING .1rLy�.
rv,
` s J ° , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-1446
Job Type: PLUMBING ONLY
Description: INSTALL 10 FIXTURES
Estimated Value:
Issue Date: 6/19/2015
Expiration Date: 12/16/2015
PROPERTY ADDRESS:
Address: 117 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: $129.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 1 IA Li CO
JOB ADDRESS: // '9 /-i qi 'e -OA PERMIT
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub __ Septic Tank&Pit
Clothes Washer i Shower i
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet Z
Hose Bibs i Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater /
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE
Bathtub
Clothes Washer
Dishwasher
Drinking Fountain
QTY TYPE OF FIXTURE QTY ��
Septic Tank&Pit
Shower
Shower Pan
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 **
** 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 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 authori to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name /Pi./ /g/ Phone Number
Plumbing Company Od✓A__'ITQgL' Pi)ir w l i fg Office Phone 7- W i? Fax 2L/'7-Q /
Co. Address: WO roll p)rf/j City RH 6e()011 State ri._ Zip,/2133
License Holder(Print): '/ /, .4 - -
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State Certification/: • ,. i ation#C FC.JiJ.Z 959
Notarized Signature of License Holder —.At.,- -- "
--
Notary PuWie State of Florida Sworn and s . cribed before me this 1 9 day of cJ al' 20 /S
tiktr, Kim Sandberg
°/aa/ My Co s oril Fr'74 Signature of Notary Public C;( 4y-v, . 7./9