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1805 ATLANTIC BEACH DR - PLUMBING ' "'= CITY OF ATLANTIC BEACH 1TS, 800 SEMINOLE ROAD 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-2535 Job Type: PLUMBING ONLY Description: PLUMBING - 19 FIXTURES Estimated Value: Issue Date: 10/27/2015 Expiration Date: 4/24/2016 PROPERTY ADDRESS: Address: 1805 ATLANTIC BEACH DR RE Number: None GENERAL CONTRACTOR INFORMATION: Name: DARLEYS PLUMBING INC. Address: 4472 PHILLIPS HWY QA CARL LESLIE DARLEY Phone: - - -- FEES: State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Plumbing Fixtures $133.00 Trade Permit Base Fee $55.00 Total Payments: $192.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 S PL3 Ph (904) 247-5826 Fax (904) 247-5845 - Z535 JOB ADDRESS: I g o�� Ai.LA-J.77-c- PERMIT# IC-CFA— 222-1 NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub 1- Septic Tank& Pit Clothes Washer 1 Shower _1 Dishwasher r Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet 3 Hose Bibs 2 Urinal Kitchen Sink �— Vacuum Breakers Laundry Tray I Water Connected Appliances Lavatory 14 Water Heater Other Fixtures Water Treating System I 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 o 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.** L3 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 10,, aao,14EA-5 Phone Number Plumbing Company OAnv-A``c ?L I JC_ Office Phone in-1-INSN Fax -7I-7-1`(4 Co. Address: £' �7Z Ptf ci-VS. tfv)Y City JAr✓rs0,0.1-C4A4 State re C- Zip 322,o'7 License Holder(Print): 4+-L L . 644-a__ State Certification/Registration # C r-05770 z Notarized Signature of License Holder OA a,_ JOANNE MEHL orn and subscribed before m this g444" day of nC *-- 201 S- Notary Public-State of Florida ignature of Notary Public �` •E My Comm.Expires Aug 29,2016 Commission #EE 829576 Bonded Through National Notary Assn.