920 MAYPORT RD - PLUMBING -j-'>>`1 f..
��' CITY OF ATLANTIC BEACH
_ _ ;) 800 SEMINOLE ROAD),:
`J 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-2289
Job Type: PLUMBING ONLY
Description: 14 FIXTURES NO CHG SEE PERMIT 15-ELEC-2261
Estimated Value:
Issue Date: 9/29/2015
Expiration Date: 3/27/2016
PROPERTY ADDRESS:
Address: 920 MAYPORT RD
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: FLINT CONSTRUCTION SVCS(PLBG)
Address: 1419 LINKSIDE DR QA RUSSELL MARK FLINT
Phone: - -
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904) 247-5826 Fax(904)247-5845 15 E(EC -ZZc l
JOB ADDRESS: 7 02o //4 o7/o4/ ha) PERMIT # l S— (0/4 — 9Q0
NEW OR REPLACEMENT INSTALLATION: Project Value$ 7, foe 9. "
TYPE OF FIXTURE QTY TYPE OF FIXTURE QT y
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain I Slop Sink —L--
Floor Drain Three Compartment Sink
Floor Sink Toilet a - 2 f/d t vi't
Hose Bibs 3 Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory d r d f.4.Az s/st- Water Heater _I
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
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 violate the rovi ions of any ther state or I cal law regulation construction or the performance of construction.
Property Owners Name 7 S Q .ve, .:* 0 t 4 Phone Number 247- /f/o
Plumbing Company F04 f &#ti1Ilvcovt C4 -rcA Office Phone ? t/— f 6X Fax 37a - gdl/
Co. Address: /1r/7 ?,J Si. I City Sd IC 'ICJ State (`L Zip /A Arc,
License Holder (Print): A..ISe ( f/.-i f State Certification/Registration# CFC 644 a P77
Notarized Signature of License Holder
Sworn and subscribed •- : e meal." da of i. 20LT
I/ �
Signature of Notary Public `=, —