1833 SHERRY DR - PLUMBING r'`
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\f-i 'f' - ' - CITY OF ATLANTIC BEACH
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- c. 800 SEMINOLE ROAD
-6 ' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
AN;-- . s.
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-1466
Job Type: PLUMBING ONLY
Description: INSTALL 12 FIXTURES
Estimated Value:
Issue Date: 6/22/2015
___ _Expiration_Date: 12/19/2015
PROPERTY ADDRESS:
Address: 1833 N SHERRY DR
RE Number: 172020-0786
PROPERTY OWNER:
Name: GETSY, STEPHEN JEFF & DENISE, *
Address: 1833 N SHERRY DR
GENERAL CONTRACTOR INFORMATION:
Name: PROFESSIONAL PLUMBING SERVICES
Address: 4524 HANOVER PARK DR MICHAEL DEAN DENARD
Phone: :7 -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $84.00
Trade Permit Base Fee $55.00
Total Payments: $143.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: / 8 3 it.PAAAI D 2 PERMIT# ls7ed ((g(
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower Z
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 .3` 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 **
** 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 authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name t‘.. �y / Phone Number
Plumbing Company AD�� Si'/l e '•'4 G MIA PIA, -Se fit4 Office Phone 37'c((`� Fax
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Co. Address: Y.�� y Alit Al 4 cell- / Z Q2 City 4-AA Statt 1 ' Zip
License Holder(Print): /44/2 / 'ice_I State Certification/Registration ft6.1v37/efL
Notari ed Si nature o License Holder . 42
skirliN JENNIFER WALKER ` 1�
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1 Before me this MY COMMISSION p FF 01148G _ day o �/
1 V Bonded EXPIRES:
Mu NotaApril ublic U derrwriers Signature of Notary Public IV to
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