352 8TH ST - PLUMBING ,t "rA��l'rJ Jr_,-,
\S, CITY OF ATLANTIC BEACH
'' l: l 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
\f-i- .2191'"
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-2360
Job Type: PLUMBING ONLY
Description: PLUMBING - 24 FIXTURES
Estimated Value:
Issue Date: 10/6/2015
Expiration Date: 4/3/2016
PROPERTY ADDRESS:
Address: 352 8th ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: TDG PLUMBING
Address: 4426 LOYS DR QA TRAVIS DALE GAINEY
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $168.00
Trade Permit Base Fee $55.00
Total Payments: $227.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 ( 5 - PLB -Z3(b
JOB ADDRESS: 3,S7.2 SjT~ S� PERMIT# 1S-S FSZ^ 19101
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE Q 1)'
Bathtub ____ Septic Tank&Pit
Clothes Washer __I____ Shower _9__
Dishwasher _ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet Si
Hose Bibs _ Urinal
Kitchen Sink __ — Vacuum Breakers
Laundry Tray __1_____ / Water Connected Appliances
Lavatory _L____ Water Heater —1_,1 Other Fixtures `�� Water Treating System
l`l
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 to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name Phone Number
Plumbing Company TM.C Q Lr b:el Office Phone S 1 S-T,M Fax S ' :— 1 71S$
Co. Address: 4-1 W41. Lcjs On. City ) y State FL Zip '" LI
License Holder(Print)71-7!2A v: 0 CA;evt State Certification/Registration# CRC-t L1"-Z.^-?OV1
Notariz ed Si g nature o f Li ' ' ' r erg 351...._:-----'
AA
Fio�,a8 6 da G . J20
�,,;.�t� NotAry public State Of � -fore me this
r �hK?9y l (,ranQm
My CommlAR�on FF 098990
xP,m�of„4,20,6 ,._nature of Notary Public
m