435 OSPREY KEY - PLUMBING 0 s .. ;s, CITY OF ATLANTIC BEACH
- 4k ')
j 800 SEMINOLE ROAD
;; - z ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
.40.13!91
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-2221
Job Type: PLUMBING ONLY
Description: 13 FIXTURES
Estimated Value:
Issue Date: 9/21/2015
Expiration Date: 3/19/2016
PROPERTY ADDRESS:
Address: 435 OSPREY KEY
RE Number: 172027-5082
PROPERTY OWNER:
Name: HICKEY ET AL, MICHAEL J
Address: 435 OSPREY KEY 435 OSPREY KEY
GENERAL CONTRACTOR INFORMATION:
Name: STEEG PLUMBING
Address: 1601 MAIN ST QA JAMES STEEG
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $91.00
Trade Permit Base Fee $55.00
Total Payments: $150.00
PERMIrr IS APPROVED ONLY IN ACCORDANCE WIIII ALL my OF AII,%..IC BEACH ORDINANCES AND THE FLORIDA
BITILDINC CODES.
r---- PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
.IOB ADDRESS: `�ni t� r7 k PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
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 I Septic Tank&Pit
Clothes Washer I Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain _ Three Compartment Sink
Floor Sink Toilet
Hose Bibs / Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater f
Other Fixtures Water Treating System r S
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 £ t RfrlI Alii.A) Phone Number
Plumbing Company' .5'7 t t / Z -.2.31c- Office Phone 204'M/' Fax
Co. Address: /Zee /'/�l t City Alt / d'1 StateF/ Zip32 3
License Holder(Print): A G fl State Certification/Registration# ee03 7/94
-
Notarized Signature of License Holder a •-/
i - e met _ day ► � U 20 ci:� Notary Public State o -Shirley L Graham r My Commission FF Expires 02/14/2018