2243 BEACHCOMBER TR - PLUMBING 1 r,'\f J'
�' s, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
'� ;� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
�J131�r
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-2308
Job Type: PLUMBING ONLY
Description: 4 FIXTURES
Estimated Value:
Issue Date: 10/1/2015
Expiration Date: 3/29/2016
PROPERTY ADDRESS:
Address: 2243 BEACHCOMBER TR
RE Number: 169463-0166
PROPERTY OWNER:
Name: STEVENS WARD F AND JANE E. *
Address: 2243 BEACHCOMBER TR
GENERAL CONTRACTOR INFORMATION:
Name: SANVILLE. MIKE PLUMBING
Address: P 0 BOX 802 QA MICHAEL RAYMOND SANVILLE
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $28.00
Trade Permit Base Fee $110.00
Total Payments: $142.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: Rae_fs �cu - re I PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value$
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 'off 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.**
[ii 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 ,S/lter 'c Phone Number
Plumbing Company /17p gP S tl(l //u-kt h l�� Office Phone T?fig if Fax3F41.
Co. Address: 53O6f i c CZ./ 5 0o2f ( City ,`a, Stater( ZipTW l
License Holder(Print): � �' Uene- state Certifica 'en/Registration#005774/0
Notarized Signature of License Holder
Ott efore me this day 20�
Notary Public State of Florida
Shirley L Graham , nature of Not Publ
oR
My Commission FF 086990 g
Expires 02/14/2018