2337 SEMINOLE RD UNIT #A - PLUMBING �S '` vs\ CITY OF ATLANTIC BEACH
r.t,y,;",', , ,, j 800 SEMINOLE ROAD
�J�'' ' �" ATLANTIC BEACH, FL 32233
\ INSPECTION PHONE LINE 247-5814
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PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-2678
Job Type: PLUMBING ONLY
Description: PLUMBING - 3 FIXTURES
Estimated Value:
Issue Date: 11/13/2015
Expiration Date: 5/11/2016 _
PROPERTY ADDRESS:
Address: 2337 SEMINOLE RD UNIT #A
RE Number: 168846-5002
PROPERTY OWNER:
Name: BOHR, SARAH H
Address: 2337 SEMINOLE RD UNIT A
GENERAL CONTRACTOR INFORMATION:
Name: PIPE WORKS LLC
Address: 8430 THORNTON CT QA JOSEPH JACK CONTOIS
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $21.00
Trade Permit Base Fee $55.00
Total Payments: $80.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND 771E FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 Q
Ph (904) 247-5826 Fax (904) 247-5845 1,5 `PL-1)�...z 67 8
JOB ADDRESS: 2 3•5") sem AI the (IU ur,I- 4% IA PERMIT# I S- 4Dj
2340
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer Shower I
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 _L_ 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:
0 Sewer Replacement n Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
0 Lawn Sprinkler System-Number of Heads 0 Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.*a
0 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 SCAM provisions of an other state or local law regulation construction or the performance of construction.
Property Owners Name M Jp \ 0 k
A ,r Phone Number
Plumbing Company Flee w 0(I3 L C Office Phone 33 oDSCj Fax
Co. Address: g3YO 1kdt\h� C�- City 01n State f l Zip 32?21
License Holder(Print): Jae Cun�1 S
State Certification/Registration # 6FC 142S-Yo2.
Notarized Signature of License Holder c,s e Q Q0 icto
.',u :._ POWWOW; I>t day dV 0 (S
W. °"'d EXPIRES:October 6,2019 I
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