134 SANY BEACH LN - PLUMBING 10 FIXTURES 01,m-rye,
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my) CITY OF ATLANTIC BEACH
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-., 800 SEMINOLE ROAD
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V)•,;?". ---1 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-1780
Job Type: PLUMBING ONLY
Description: 10 FIXTURES
Estimated Value:
Issue Date: 7/24/2015
Expiration Date: 1/20/2016
PROPERTY ADDRESS:
Address: 134 SANDY BEACH LN
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: ADVANTAGE PLUMBING
Address: 880 MAYPORT RD QA GREG GAUSE
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $70.00
Trade Permit Base Fee $55.00
Total Payments: $129.00
PERMIT IS APPROVED ONLY IN ACCORDANCE 'WITH ALL (TIN OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
if/800 Seminole Rd Atlantic Beach, FL 32233 / -.//
Ph(904)247-5826 Fax(904) 247-5845 ._____4____
JOB ADDRESS: /3 :,iczik :.1 2 PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub / Septic Tank&Pit
Clothes Washer l Shower _i_
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink _ Toilet Z
Hose Bibs / Urinal
Kitchen Sink / Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory . Water Heater /
Other Fixtures Water Treating System D
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 **
**SIRWD 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 30:LCA / L* Phone Number
Plumbing Company adVaKY7%2 / 1, lf)ii'1ot Office Phone 7 /7-9W Fax i iq Q I
Co. Address: i car+Rcl ✓J City/)+I 7,5e Cii State/L Zip 32233
License Holder(Print): :) '1, . - _ State Certificatio t - ki 1 .tion#CFelhiZf 9$q
Notarized Signature of License Holder _,J r` 4_
Notary Fume State of Florida Sworn and s • cribed before me this
Ze day of N. J/y 20 /S
Kim Sandberg
qi.V' E>�z 9 oang 164674 Signature of Notary Public /)-Y1";_ 7i'l.ei&Z_,9