1122 E LINKSIDE CT - PLUMBING 1 - `1
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S f CITY OF ATLANTIC BEACH
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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-2202
Job Type: PLUMBING ONLY
Description: 3 FIXTURES
Estimated Value:
Issue Date: 9/17/2015
Expiration Date: 3/15/2016
PROPERTY ADDRESS:
Address: 1122 E LINKSIDE CT
RE Number: 172374 5110
PROPERTY OWNER:
Name: BROWN, JACOB S
Address: 1122 E LINKSIDE CT
GENERAL CONTRACTOR INFORMATION:
Name: SEAN WILLIAMS PROFESSIONAL
Address: 7011 MCNEILL RD QA SEAN DEREK WILLIAMS
Phone: - - ----
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $21.00
Trade Permit Base Fee $55.00
Total Payments: $80.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WI 1.11 ALL (TIN OF ATLANTIC BEACH ORDINANCES AND TIIE FLORIDA
IRIILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904) 247-5845
JOB ADDRESS: ! 1 I !'1 KSi �Ga PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ JJOO
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 **
**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.
O
Property Owners Name al,G atp ,/fin Phone Number
Plumbing Company�tgam Wit Aa,,5 Pr61 PGu (0c,.5 Office Phone?7a`f3 7? Fax- 7c2. 7c 1,1
Co. Address: �{V4 Mc et`( I?,, . City 34 x State Ft Zip 3 2c "-
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License Holder(Print):� ee.rt U3 t I Ct, State Certification/Registration#(',.„,�
Notarized Signature of License Holder
Before me this / 7 say, -14 r. 20
Signature of Notar Publi ' _ : -