604 TIMBER BRIDGE LN - PLUMBING 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-1971
Job Type: PLUMBING ONLY
Description: PLUMBING - 21 FIXTURES
Estimated Value: $10,000.00
Issue Date: 8/20/2015
Expiration Date: 2/16/2016
PROPERTY ADDRESS:
Address: 604 TIMBER BRIDGE LN
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: CRABTREE PLUMBING INC
Address: 2351 URBAN RD QA JEFFREY W. CRABTREE
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $147.00
Trade Permit Base Fee $55.00
Total Payments: $206.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALI. CITY OF ATLANTIC BEACH ORDINANCES AND TIIE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 i 5 - p t f, 4977 (
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: (.PO4 1 SYl k fbc I d9 I...ccn e PERMIT# � s h -1 01
NEW OR REPLACEMENT INSTALLATION: Project Value$ /6 deo. 0
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub a Septic Tank&Pit
Clothes Washer I Shower /
Dishwasher ___1__ Shower Pan /
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet if
Hose Bibs L. Urinal
Kitchen Sink I• Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
106-ki—SoCfna
RE-PIPE: 0
TYPE OF FIXTURE QTY TYPE OF FIXTURE QT •
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 c,/)0 r\ez Phone Number eR%/ O - Q
Plumbing Company 0 r�,bkt'e'e `f (.c n b i c ilV( . Office Phone 914 3' q Fax 3W--'et Cir
Co. Address: !-)&I 16N b C W1 Cit ucLC,t�CYI Y i (If State Zip 3221 b
License Holder(Print):
-----
Q-W re 9 1, r G bkte State_Certification/Registration#( -CO 3 scot k
Notarized Signature of License Holder
4°`"R:po4 Before me is �FTI1L day of 4 k .,. 8" 20 S
* * ti1v�wEru felaka/
\'" "'besot 7 Signature of Notary Pu h � i� A
N. F,,• '
l�lFOFFtOR�Oe� �uS.Octobers 2016