304 1ST ST PLUMB '._ /'
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
/ ( ,•;
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16 -PLBG -1036
Job Type: PLUMBING ONLY
Description: PLUMBING - 3 FIXTURES
Estimated Value:
Issue Date: 5/4/2016
Expiration Date: 10/31/2016
PROPERTY ADDRESS:
Address: 304 1ST ST
RE Number: 169736 -0100
PROPERTY OWNER:
Name: OBANNON, PAULA R
Address: 304 1ST ST
GENERAL CONTRACTOR INFORMATION:
Name: WILLIAM'S BIG BOY PLUMBING INC
Address: 516 SOUTH 11TH AVE QA WILLIAM WAGNER GOODLING
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $21.00
Trade Permit Base Fee $55.00
Total Payments: $80.00
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: 304 1 S+ STtLe6T PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 1 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 'L Water Heater
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 1 pto re (o ca k"e f(wf t>aft4 JcJc
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 Pt .L 1A CY %POO 0 Phone Number W11
Plumbing Company LY% \ \: Volt I ' . Office Phone Fax
Co. Address: 5N4 1A' keat+k S c� City J ."" &eic.44 State FL Zip 3 V)
License Holder (Print): U; Pp.. GO o Q a G. State Certification/Registration # RFOOI.I.I03
Notarized Signature o License Holder 1 ! ■No..
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•; ��., EXPIRES: October 6, 2019 &MK
•t,jia * Bonded Thru Notary Pubfig L4 • is t; of Notary Public