1872 HICKORY LN - PLUMBING e L'Al‘i-1)6
\I 4
6 CITY OF ATLANTIC BEACH
A ;) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
4s
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-1508
Job Type: PLUMBING ONLY
Description: 2 FIXTURES
Estimated Value:
Issue Date: 6/24/2015
Expiration Date: 12/21/2015
PROPERTY ADDRESS:
Address: 1872 HICKORY LN
RE Number: 172020-1458
PROPERTY OWNER:
Name: PIERSON,
Address: 1872 HICKORY LN
GENERAL CONTRACTOR INFORMATION:
Name: ALDRIDGE & SONS PLUMBING
Address: 1236 N FRUIT COVE DR QA WILLIAM T. ALDRIDGE
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 CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION �D
CITY OF ATLANTIC BEACH _
800 Seminole Rd Atlantic Beach, FL 32233 /6 /9t/6
Q Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: I f U2- F 7ck0's y I.. i\) PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value$ 000
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan 2
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 **
**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 F i ecS011\ Phone Number
Plumbing Company /-ldrj 450 Plum b i r Office Phone x'6`/,28'739.53 Fax 9)51:2a-32 30
Co. Address: 51 SI Su to b Jett w► Rd. t S City TaX State ¶I Zip3 22 6
License Holder(Print): William T4 d r t e_ State Certification/Registration# 1'9 2.( z 35-•
Notarized Signature of License Holder % #'i •
efore me this o?1 da _ 2�l
_o "` . Notary Public State of Florida
Shirley L Graham ignature of Notary Put
-
140, My Commission FF 086990
"For1w' Expires 0V14/2018