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1763 Atlantic Beach Dr - Plumbing 26 Fixtures �• 16 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD t) ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 ' \J131 Jr PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814 JOB INFORMATION: Job ID: 16 -PLBG -413 Job Type: PLUMBING ONLY Description: 26 FIXTURES Estimated Value: Issue Date: 2/18/2016 Expiration Date: 8/16/2016 PROPERTY ADDRESS: Address: 1763 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 State PLMG DCA Surcharge $2.00 State PLMG DBPR Surcharge $2.00 Plumbing Fixtures $182.00 Total Payments: $241.00 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: _ 1763 ATLANTIC BEACH DR. PERMIT # 16- SFR -54 NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub 1 Septic Tank & Pit Clothes Washer 1 Shower 4 Dishwasher 1 Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet 4 Hose Bibs 3 Urinal Kitchen Sink 1 Vacuum Breakers Laundry Tray 1 Water Connected Appliances 2 Lavatory 5 Water Heater 2 Other Fixtures Water Treating System 1 RE -PIPE: 2 �" 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 performance of construction. Property Owners Name Glen Layton Homes 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): C4 L A4 �`. State Certification/Registration # CFC 056702 Notarized Signature of License Holder e worn and subscribed before I e this 4 day of Flbl'u Q r 20 I( P ?,• �`� : Notary Public JOANNE State H of Florida • . a /;�� • Tii t My Comm. Expires Aug 29, 2016 ignature of Notary Public ,, Commission # EE 829576 ,, "" Bonded Through National Notary Assn.