598 SEASPRAY AVE - PLUMBING 2 SS, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J r 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-1025
Job Type: PLUMBING ONLY
Description: PLUMBING - RE-PIPE AND 12 FIXTURES
Estimated Value:
Issue Date: 5/3/2016
Expiration Date: 10/30/2016
PROPERTY ADDRESS:
Address: 598 SEASPRAY AVE
RE Number: 170703-0432
PROPERTY OWNER:
Name: BAKER ET AL, JAMES W
Address: 598 SEASPRAY AVE
GENERAL CONTRACTOR INFORMATION:
Name: DALE'S PLUMBING COMPANY
Address: 688-C Kingsley Ave Orange PARK
Phone: 904-269-5430
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $84.00
Trade Permit Base Fee $55.00
Total Payments: $143.00
PERMIT IS APPROVED ONLY IN ACCORDAN(:E WITII ALL CITY OF :t I LAN I IC BEACH ORDINANCES AND THE FLORIDA
Rl hI.DING CODES.
I
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 1 (0 - PL 6 6 - 015
JOB ADDRESS: .0., e ' // PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub / Septic Tank&Pit
Clothes Washer Shower
Dishwasher I Shower Pan `'
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 2. Water Heater
/
Other Fixtures - Water Treating System
RE-PIPE:
TYPE OF FIXTURE QT 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 0 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 rC i c
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 auth 'ty to violate the pr isions of an other state or local law regulation construction or the performance of construction.
Property Owners Name CO B4 �v r` �J Phone Number 9v5/ 7d•, 3 777
. -
Plumbin Company l�/e,./ ��Uti6, (0 -,- ^ c Offic - d g p Y (> ���_ Office Phone ,�G f° ,j-f%�<J Fax ��9- �� l
Co. Address: 6f C i % Ac_/ City State J� Zip O7
/7 o P , p
License Holder (Print): ( 7e 4/41 ,• ' State Certification/Registration# C/`C°�J y�/„zrJ�
Notarized Signature o • •. • .._.. -/
TONI GINDLESPER ''
= �y MYCOMMI�€ •r day o 161� 20
*.. :; EXPIRES Cc o er r =1
Public Underwriters
'Ziif:A`; Tbtu - -- -- •otary Public ti�I ar