1611 FRANCIS AVE - PLUMBING FOR WATER SOFTNER (' ' ''' \s, CITY OF ATLANTIC BEACH
„,"`- f 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: 16-PLBG-209
Job Type: PLUMBING ONLY
Description: WATER SOFTNER
Estimated Value:
Issue Date: 1/27/2016
Expiration Date: 7/25/2016
PROPERTY ADDRESS:
Address: 1611 FRANCIS AVE
RE Number: 172285-0040
PROPERTY OWNER:
Name: BISSONETTIE, CAROLINE ELLEN
Address: 1611 FRANCIS AVE
GENERAL CONTRACTOR INFORMATION:
Name: AFFORDABLE WATER/KINDER INC
4 Address: 3760 KORI RD SPECIALTY WATER (CONS TDS QB)
Phone: - -
FEES:
Trade Permit Base Fee $55.00
Plumbing Fixtures $7.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Total Payments: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax(904) 247-5845
•JOB ADDRESS: /60 / i Fi2AA4C 5 AVFNUE•1 A1`ATIfic -Beach PERMIT#
32233
NEW OR REPLACEMENT INSTALLATION: Project Value$ £o( •00
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 _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 ❑ 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 perfor mance nce of construction.
be...-441 2
Property Owners Name E Lt zA B A L d R=E Phone Number 31- 13- iv
904_
Plumbing Company AFFo R DA A LE WAVER- Office Phone 242-0197 Fax 7-60-1029 2
Co. Address: 3 760 K 0 R■ ROA 0 City c.Ks nu 1 tI e State FL Zip 3 2 -61
State Certification/Re istration# WO 8 18
License Holder(Print): 11 • . � • >• • L g
Notarized Signature of License Holder . - —
„ ,ry Pib1� Sworn and subscribed bef e this j I day of��ua la 20.. ..14 ci Florida
My ct 854381 Signature of Notary P lic ►‘'1fier..« 1111 iiii.
,,,,,p,ir Expires 0210912017