971 Paradise Circle PLUMBING , ANTIC BEACH
000)
, ,.`S, CITY OF ATLANTIC
J 800 SEMINOLE ROAD
j t,. 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-872
Job Type: PLUMBING ONLY
Description: 20 FIXTURES NEW SERVICE
Estimated Value:
Issue Date: 4/13/2016
Expiration Date: 10/10/2016
PROPERTY ADDRESS:
Address: 971 PARADISE CIR
RE Number: 172376-0080
PROPERTY OWNER:
Name: BOB & CHRIS LLC., *
Address: 357 12TH ST
GENERAL CONTRACTOR INFORMATION:
Name: DARLEYS PLUMBING INC.
Address: 4472 PHILLIPS HVVY 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 $140.00
Total Payments: $199.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: 7 I Parq d,'s e C.I.r PERMIT#16-SIR -301
NEW OR REPLACEMENT INSTALLATION: Project Value$ t i 000'1'
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 3 Septic Tank&Pit
Clothes Washer I Shower I
Dishwasher I 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 c�
Laundry Tray I Water Connected Appliances //"
Lavatory 4 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 ❑ 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 .80,..6 4 C ti,►s L L C. Phone Number 850-702-6790
Plumbing Company Ocjciee1s fllvM h►6/.0, Office Phone 7 ,7- / 989 Fax-7,A 7-/YS
8
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Co. Address: ! '7a, Ph,'//,o S Aii-■ City Tc,c k'So.- c...//r State Ft Zip( a 0 7
License Holder(Print): Co.e/ L U a r/e2 State Certification/Registration#CFC (9,4'670 2
Notarized Signature of License Holder c. ,go
Before me this 6b day "k `l 201(p
O.``HY JOP.NNE MEHL � b day of W
AP GBH�,
•_� ��: Notary Public-State of Florida
• 4! . •;My Comm.Expires Aug 29,2016 Signature of Notary Publ. 'tf14 I
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