907 STOCKS ST - PLUMBING St,
„ ' ,:,,
A CITY OF ATLANTIC BEACH
, j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-1728
Job Type: PLUMBING ONLY
Description: SHOWER PAN
Estimated Value:
Issue Date: 7/20/2015
Expiration Date: 1/16/2016
PROPERTY ADDRESS:
Address: 907 STOCKS ST
RE Number: 170951-0000
PROPERTY OWNER:
Name: GIACHETTO. LINDA A
Address: 2865 FORT WILDERNESS TR
GENERAL CONTRACTOR INFORMATION:
Name: LARRY TEAGUE & SONS PLUMBING
Address: 203 OCEANFRONT QA ARNOLD GEORGE BENNETT
__P_hone: - -
FEES: ��
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures S7.00
Trade Permit Base Fee $55.00
Total Payments: $66.00
IniiiiminiiimiiimiimmiimilimiliiiimmlimERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
/� Ph (904) 247-55�n826o Fax (904) 247-5845
JOB ADDRESS: G l/ t fb 7-t w� 322_33 2 PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ Ivil1/4,, O
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
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 specifi
or not. The permit does not give a thorrity tq violate he provisions of any other state or local law regulation construction or the performance of constructio .
Property Owners Name Phone Number s 3g
Plumbing Company La o°r onS-P1 v mb I AVffice Phoneai 0-2 < FaxZ Y 'Sall
Co. Address: 2°5 V ' + City MylihritiNAthe II Zip 3Z2 3
License Holder(Print): *. I t •.. _a I a State Certification/Registration#2-1521
Notarized Signature of License Holder f ri
Sworn and subscribed befo e me his 20±L day !f. V 2015/
Signature of Notary Publi CL ' l Wilk