260 CAMELIA ST 16-PLBG-637 6 Fixtures CITY OF ATLANTIC BEACH
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-637
Job Type: PLUMBING ONLY
Description: repipe 6 fixtures
Estimated Value:
Issue Date: 3/16/2016
Expiration Date: 9/12/2016
PROPERTY ADDRESS:
Address: 260 CAMELIA ST
RE Number: 170865-0000
PROPERTY OWNER:
Name: NEAL, JOYCE J
Address: 260 CAMELIA ST
GENERAL CONTRACTOR INFORMATION:
Name: EAGERTON PLUMBING CO.
Address: 1093 N MCDUFF QA NONE SEE NOTE
Phone: - -
FEES:
Trade Permit Base Fee $55.00
State PLMG DCA Surcharge $2.00
State PLMG DBPR Surcharge $2.00
Plumbing Fixtures $42.00
Total Payments: $101.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH .
800 Seminole Rd Atlantic Beach, FL 32233
•
Ph(904)247-5826 Fax (904)247-5845
OB ADDRESS: -7J CA"At N 1 k Sk PERMIT#
• W OR REPLACEMENT INSTALLATION: Project Value$
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
Vacuum Breakers
Kitchen Sink Water Connected Appliances
Laundry Tray Water Heater
Other Fixtures
Lavatory Water Treating System
Other
tE-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 _I—.
Hose Bibs —_L__ Urinal
Kitchen Sink _L.— Vacuum Breakers
Laundry Tray Water Connected Appliances ___r_
Lavatory ,....4____. Water Heater
Other Fixtures Water Treating System
VIISCELLANEOUS: allons(Requires 3 sets of plans)
3 Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) g
3 Lawn Sprinkler System-Number of Heads
0 Well **
Ir* SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
Other
his application becomes void if work does not bemmeand within a All provisions of work is suspended or abandoned for six
ordinances governing this work will be complied with whether specified
his application and know the same to ri true and P
x not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance construction.
��on.
�,S a- Phone Number 111
Property Owners Name 98�c�q�
Plumbing Company E&� Q � Office Phone 3 96-0-1, 4 Fax'
Co. Address:
`O'\2 Me-D' Q�A/ City )iL■G State f..Zip ;2251
License Holder (Print): 1 I, 24-,/t"S (IFIr St to Certification/Registration#
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� i .*., kw or Florida Sworn and subscribed before me this_ _G_--day of
I Y,'_ii **•Fi 1114266 Signature of Notary Public
t4,,. ' My Comm.Eo1 m Jv 20.2010