545 CRUISER LN - PLUMBING . .T LAN....
CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
J V .. _. —` , ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
03119'
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-2332
Job Type: PLUMBING ONLY
Description: 1 WATER HEATER
Estimated Value:
Issue Date: 10/5/2015
Expiration Date: 4/2/2016
PROPERTY ADDRESS:
Address: 545 CRUISER LN
RE Number: 170703-0340
PROPERTY OWNER:
Name: DAVID,EDUARDO M & EVANGELINE P, *
Address: 545 CRUISER LN
GENERAL CONTRACTOR INFORMATION:
Name: ECONO 0 ROOTER INC
Address: 9020 COCOA AVE LEROY BLANTON
Phone: - -
FEES: - - ---State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $7.00
Trade Permit Base Fee $55.00
Total Payments: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904)247-5845
JOB ADDRESS: YS Offit-/-5 61e- PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ E Go __
TYPE OF FIXTURE QTY TYPE OF FIXTURE: QT I'
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 S.stem ________
MISCELLANEOUS:
o Sewer Replacement E. Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
o Lawn Sprinkler System-Number of Heads o 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 tnte 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 4 S Phone Number 3 2 -?S 7 V
Plumbing Company_ (LCD DO ea O - Office Phone 3.2.7_ 3 P Fax .7 22 ) G
Co. Address: 90 00 C,90_ f).o City c1 ./C State F! Zip 322J1
License Holder(Print): • " 1
' 7b1J .tote Certification/Registration # ��COS/IoSZ,
. !Notarized Signature of License Holder 1, 11417
NMI%
Sworn and subscribed before me t•'s J day of La Ie1 20 45'
o�'"��` � LINDA M SPEISER •
:' 9219 Signature of Notary Public '
MY COMMISSION#FF10
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e EXPIRES April 2, 2018
(407;"398-0153 FloridallotaryService.COm