1661 PARK TER E - PLUMBING C r\iy�
,\(S� CITY OF ATLANTIC BEACH
"" 800 SEMINOLE ROAD
r ATLANTIC BEACH, FL 32233
w INSPECTION PHONE LINE 247-5814
'�J i319 r'
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-911
Job Type: PLUMBING ONLY
Description: 20 FIXTURES
Estimated Value:
Issue Date: 4/19/2016
Expiration Date: 10/16/2016 _
PROPERTY ADDRESS:
Address: 1661 E PARK TER
RE Number: 172020-0216
PROPERTY OWNER:
Name: KETTERINGHAM ET AL, BARNEY B
Address: PO BOX 20229 PO BOX 20229
GENERAL CONTRACTOR INFORMATION:
il Name: RYAN RAMSEY PLUMBING INC
Address: 198 Foxridge RD
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: $199.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TIIE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: `/ 1 / R, f-„ ,,,i'*cE AS7 PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 3 Septic Tank&Pit
Clothes Washer / Shower a1
Dishwasher t Shower Pan
Drinking Fountain Slop Sink
Floor Drain _ Three Compartment Sink 1
Floor Sink Toilet
Hose Bibs 2 Urinal
Kitchen Sink _j__ Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory , . Water Heater ?r)
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.**
El 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 Phone Number
Plumbing Company eyb A3 1+1'%1A4-5E P/ A-im•h f^'J 1-'C Office Phone /44/ ?tilax
Co. Address: /7g- FO><6e1 'r° City 6/,E_ ” ,e- Aek State G Zip 3.)6'63--
.)6'6
License Holder(Print): leyfl\") c orv"LS t=y : ate ertification/Registration# C RG 140S'S/g
Notari ei: ' , • , I , .1 er
ce °45 . Notary Public State of Florida /
Shirley(.Graham :•.fore me this l da.11 ♦v//ci /A'7 20 /6
o My Commission FF 086990
pFt�p4 Expires 02/14!2018
gnature of Notary Publt. ( 5.,e.
79 -31/5. .D •