109 BEACH AVE - PLUMBING (2) 1r\J'r
, # . � , CITY OF ATLANTIC BEACH
'' '° ~. •f 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: 16-PLBG-521
Job Type: PLUMBING ONLY
Description: PLUMBING - 15 FIXTURES
Estimated Value:
Issue Date: 3/2/2016
Expiration Date: 8/29/2016
PROPERTY ADDRESS:
Address: 109 BEACH AVE
RE Number: 170212-0000
PROPERTY OWNER:
Name: FECHTEL FAMILY JNT VENT ET AL
Address: 6830 MEADOW RD
GENERAL CONTRACTOR INFORMATION:
Name: SUNSHINE STATE PLUMBING
Address: 1340 TRAILWOOD DR MICHAEL TROY PORTER
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $105.00
Trade Permit Base Fee $55.00
Total Payments: $164.00
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 ( ( --PL, - SZ (
JOB ADDRESS: (OS c_c.GL, /4 Vt_ /fl l c n-r+e_ 13z cc_1, F L 3Z233PERMIT# X-SFR- Z(18
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer
I Shower z
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet '2-
Hose Bibs 2 Urinal
Kitchen Sink 1 Vacuum Breakers 3
Laundry Tray Water Connected Appliances
Lavatory 2. Water Heater _i
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:
Sewer Replacement n Back Flow Preventer t i Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
I... Lawn Sprinkler System-Number of Heads H Well **
** SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
"
.1 Other COnnecIi,5 to /h e e,s Mt145 4 p✓c. Suer'
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 _insP1(z- Nor'vr$ jic.- Phone Number 9t (/- 237-271(
Plumbing Company SO h Sk;h z. S'fe'F, ?Jun"b;)ts Office Phone c/Qq-262-1066 Fax 5I&/-262-0955
Co. Address: ) /Q (4Cl YI-t-S 51 City j C,ekSby,villti State Fc Zip 3ZZ02.
License Holder (Print): iVi:cckC{ I r 19Or{r State Certification/Registration# CfC1926855
Notarized Signature of License Holder t)
.§iS"R"- !y1, PATRiCIA KINHOFER Sworn and subscribed before me t • z day of 41("4 20 l G
„ MY COMMISSION 9 EE 829015 6'�
, '`�r'` ,* EXPIRES:December 22,2016 Signature of Notary Public
''Fa,,,dw` Bonded Tfru Budget Notary Services
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