1691 ATLANTIC BEACH DR - PLUMBING S r�,�J�
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\1, CITY OF ATLANTIC BEACH
r .,.. ,) 800 SEMINOLE ROAD
J .7, 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-2793
Job Type: PLUMBING ONLY
Description: NEW PLBG 22 FIXTURES
Estimated Value:
Issue Date: 12/2/2015
Expiration Date: 5/30/2016
PROPERTY ADDRESS:
Address: 1691 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: DARLEYS PLUMBING INC.
Address: 4472 PHILLIPS HWY QA CARL LESLIE DARLEY
Phone: - - _
FEES:
Trade Permit Base Fee $55.00
Plumbing Fixtures $154.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Total Payments: $213.00
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:_1691 ATLANTIC BEACH DR PERMIT# 15—SFR-2472
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 2 Septic Tank& Pit
Clothes Washer I Shower 1
Dishwasher 1 Shower Pan I
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs 2 Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray I Water Connected Appliances 2
Lavatory 5 Water Heater 1
Other Fixtures Water Treating System 1 ///
1/2
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 c 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.1 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 Toll Brothers Inc Phone Number
Plumbing Company Darley's Plumbing Inc Office Phone 904-727-1484 Fax 904-727-1485
Co. Address: 4472 Phillips Hwy City Jacksonville State FL Zip 32207
License Holder(Print): r(4 R L L ��0au ii- State Certification/Registration# CFC 0TH?°2-
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(rfl Notary Public-State of Florida l Sworn and subscribed before e this day of 2ce�bo 20 y Comm.Expires Aug 29.2016 � I
F Commission 0 EE 829576 '
( Bonded TnrougI National Nagy Aam. 1 Signature of Notary Public .��►