96 ARDELLA RD UNIT B - PLUMBING _SS,� CITY OF ATLANTIC BEACH
- 800 SEMINOLE ROAD
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-2032
Job Type: PLUMBING ONLY
Description: 12 FIXTURES
Estimated Value:
Issue Date: 8/27/2015
Expiration Date: 2/23/2016
PROPERTY ADDRESS:
Address: 96 ARDELLA RD B
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: CANNON PLUMBING, INC.
Address: 1794 -1002 ROGERO RD QA OLIN MARSHALL CANNON
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $84.00
Trade Permit Base Fee $55.00
Total Payments: $143.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
" '. .ate
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: CU 1:\A& 1a c. 8 PERMIT# \t-rV( )(-)51`
NEW OR REPLACEMENT INSTALLATION: Project Value$ .
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 0 Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan •
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet L‘
Hose Bibs Urinal
Kitchen 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
'emit 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
his 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
>r 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.
?roperty Owners Name Phone Number
'lumbing Company Cairmr , ,\:5iYYJ,Ty,e. Office Phone 7 w,a oFaxciO4- \-(f-itG
:o. Address: \ -k-oglorx,c k y„A City c vh,o,,,,,;i6 State VL Zip 3Qa\)
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,icenv �1 ic4111{ 1): "6- `� State Certification/Registration# (PG/'f2G/if
Vota�iz@ a�' a .q{l icense Holder
T* •••• •• Sworn and subscribed before me this day of S \
\ 20
OFF OB2270 • ..
�' ),A\ ,, sondes ' `�°Q Signature of Notary Public F'. . , _�,
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