1739 ATLANTIC BEACH DR PLUMBING 2015 CITY OF ATLANTIC BEACH
ij 800 SEMINOLE ROAD
r� ATLANTIC BEACH, FL 32233
J V INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-1566
Job Type: PLUMBING ONLY
Description: SEE 15-PLBG-1535 21 FIXTURES NEW
Estimated Value:
Issue Date: 6/30/2015
Expiration Date: 12/27/2015 __--------------
PROPERTY ADDRESS:
Address: 1739 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: DARLEYS PLUMBING INC.
Address: 4472 PHILLIPS HWY QA CARL LESLIE DARLEY
---Phone:
__P_hone: - - -
FEES:
Total Payments: $0.00
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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
Boo Seminole Rd Atlantic Beach.FL 32233
Ph(904)247-5826 Fax(904)247-5845
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PERMIT#
.TOB ADDRESS: -139 Asw.t-z� l�r,tw,♦ Qt
NEW OR REPLACEMENT INSTALLATION: Project Value S__.______._
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Z Septic Tank&Pit t t h
Shower
Clothes Washer — I Shower Pan t
Dishwasher —I Slop Sink
Drinking Fountain Three Compartment Sink
Floor Drain Toilet --�--
Floor Sink Urinal
Hose Bibs Vacuum Breakers
Kitchen Sink Water Connected Appliances �—
Laundry Tray Water Heater
Lavatory Water Treating System
Other Fixtures
RE-PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Shower
Clothes Washer Shower Pan
Dishwasher Slop Sink
Drinking Fountain Three Compartment Sink
Floor Drain Toilet
Floor Sink Urinal
Nose Bibs Vacuum Breakers
Kitchen Sink Water Connected Appliances
Laundry Tray Water Heater
Lavatory Water Treating System
Other Fixtures
MISCELLANEOUS: gallons(Requires 3 sets of plans)
Sewer Replacement ❑Back Flow Preventer Grease Interceptor(Trap) ;*
Lawn Sprinkler System-Number of Heads
�- Well
**SJR WD Well Completion Form.Completed'form be submitted to the Building Department for final inspection•**
Other
Permit becomes void if work does not commence within a six month Period or wont is
suspended ce abandoned for six months.I hereby certify that 1 have read
P
All rovisions of laws and ordinances governing this work will be complied with whether specified
this application and know the same to be true and correct.
or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance o4 99 structrop.
Phone Number ?S
Property Owners Name �.i W`t J{or f�
__-.'tsac L Office Phone lt�-I'13N Fax 12�
Plumbing Company � State Fe Zip
y City �h'►'
Co.Address: 49 7Z D't`r -VS Ilw' CFLor67oL
License Holder(Print):
C AA.t. � A-9 State Certification/Registration#
Notarized Signature of License Holder s day of 205—
Sworn and subscribed beforemk
JOANNE MEHL
i os Notary Public-State of Florida Signal of Notary Public
My Comm.Expires Aug 29.2016 _
ted: CommisWn r EE 829576
••°.,`.
so Through National NMary Assn.