1566 W PARK TER - PLUMBING r„1,J.\J„ ,
'.:. ;, CITY OF ATLANTIC BEACH
r. A _s 800 SEMINOLE ROAD
Kir' -,- ATLANTIC BEACH, FL 32233
�f, C) INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-2779
Job Type: PLUMBING ONLY
Description: 14 fixtures
Estimated Value:
Issue Date: 12/1/2015
Expiration Date: 5/29/2016
PROPERTY ADDRESS:
Address: 1566 W PARK TER
RE Number: 171941-0000
PROPERTY OWNER:
Name: PHILLIPS, DONALD L & BARBARA B, *
Address: 1566 PARK TER
GENERAL CONTRACTOR INFORMATION:
Name: STEEG PLUMBING
Address: 1601 MAIN ST QA JAMES STEEG
Phone: - -
FEES:
Trade Permit Base Fee $55.00
Plumbing Fixtures $98.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Total Payments: $157.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax(904)247-5845
JOB ADDRESS: /5 t FA �.4 e— J 2 PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
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 Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 7 Septic Tank&Pit
Clothes Washer _Z____ Shower _/ .
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet t3
Hose Bibs —1_ Urinal
Kitchen Sink Vacuum Breakers
(-4,
Laundry Tray Water Connected Appliances I
Lavatory ,3 Water Heater _i
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 ®Dl) PX l illes Phone Number
Plumbing Company c /1 ( .X� Office Phone 299 94( Fax
Co. Address: £Oi �P/� Sr City "'eh State)/ Zip32.233
License Holder(Print): -11 hl, 5fr State Certification/Registration### '-037/9'
Notarized Signature of License Holder 41141., //
fore m P's il■' day - A f,/20 /6
60,Pie Notary Public State of Florida o ��
N. Shirley L Graham filature of Notary rub!: !_ t
.3.1;-0 o My Commission FF 086990 - •
,�ofi Expires 02!1412018