1649 atlantic beach dr - plumbing mr)
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CITY OF ATLANTIC BEACH
A -. 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-1760
Job Type: PLUMBING ONLY
Description: PLUMBING - 20 FIXTURES
Estimated Value:
Issue Date: 7/23/2015
Expiration Date: 1/19/2016
PROPERTY ADDRESS:
Address: 1649 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: DON HARRIS PLUMBING CO.,INC.
Address: PO BOX 14668 QA NELSON D. HARRIS
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $140.00
Trade Permit Base Fee $55.00
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Total Payments: $199.00
P•RNIIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC' BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH 15 -P/_ 3 -/7 Q
800 Seminole Rd Atlantic Beach, FL 32233
A24726F7.584 h(904) 5 �,
JOB ADDRESS: CP C AERmriJ L. D
NEW OR REPLACEMENT INSTALLATION: Project Value$ /1, O
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Z Septic Tank&Pit
Clothes Washer I Shower —"I—
Dishwasher I Shower Pan 2
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet —
Hose Bibs 2- Urinal
Kitchen Sink / Vacuum Breakers
Laundry Tray I Water Connected Appliances
Lavatory 5 Water Heater
Other Fixtures / aJtIC. 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 pr 'lions of any o r state or local law regulation construction or the performance of construction.
Property Owners Name /0/f ,LJ2' S Phone Number
Plumbing Company Don Harris Plumbing Co., Inc. Office c 072 oq(bFax299 23$8
Co. Address: () , Ilb ( .....1- ' City Sta—ta, Zips Z Z ID
License Holder(Print): EL 513/1/ _ . '�Lie,e!5 State ertification/Registration# e.F Di q I7
NotarizedSifnature of 1 icrn.cP older ���
!r'"f` KIM BUTLER
i<` Commission#FF 030749 Sworn and subscribed before m: this day of 20
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Expires October 25,2017
• , B01�'di""'T10J�F'"'uu"nc' "70t° Signature of Notary Publi /A. BO