1135 LINKSIDE CT- PLUMBING ,)" \ \ CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
JN.,,,_______// ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
'4.0;319''
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-1262
Job Type: PLUMBING ONLY
Description: PLUMBING - REPAIR IN GARAGE
Estimated Value:
Issue Date: 6/7/2016
Expiration Date: 12/4/2016
PROPERTY ADDRESS:
Address: 1135 W LINKSIDE CT
RE Number: 172374-5170
PROPERTY OWNER:
Name: MANIS, STEPHEN V & LANE JETER, *
Address: 1448 W LIBERTY ST
GENERAL CONTRACTOR INFORMATION:
Name: CANNON PLUMBING, INC.
Address: 1794 -1002 ROGERO RD QA OLIN MARSHALL CANNON
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $7.00
Trade Permit Base Fee $55.00
Total Payments: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
M 800 Seminole Rd Atlantic Beach, FL 32233 •
Ph(904)247-5826 Fax(904)247-5845 i Co - PL f3 - )z(o z
JOB ADDRESS: 113 S L-%"(1 i Sr de,. Ci1v - €5 "' PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
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
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE: ,
TYPE OFFIXTUREQTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank&Pit
Clothes Washer I Shower
.Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs 2 Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 2. Water Heater I
Other Fixtures Water Treating System
MISCELLANEOUS:
o Sewer Replacement 0 Back Flow Preventer o Grease Interceptor (Trap) -gallons(Requires 3 sets of plans)
a Lawn Sprinkler System-Number of Heads a Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
a Other ��� in .itivn Gar see/ ,vviiG-1 en.licl dr 1°"`,� prf''ti AU;414- 'fin
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 Lwow the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. Thc permit dbc4 not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name LAW e, ('Ayi S Phone Number I®'f-G,2'- $-i g'-'1"
Plumbing Company C4 N non 0 u r1•Ij 7ric, Office Phone 9®'`f-`7'1 434 Fax gest-6-61-cog
Co. Address: I'-i i( E . G hGo il City vko w J ie State >f Zip 3 -2112-1
License Holder(Print): Z i I'll C an na Yl State Certification/Registration# (-FG- 1'66140
Notarized Signature of License Holder
; ' � LESGALE Sworn and subscribed before me this / 1 day of 5t'`^er 20 14
I..' LESLIE DALE Commission#FF 144322 .�— '
. .
;_'.I Expires July 23,2018 Signature of Notary Public
• ,!R.,,••, Swamr..Troy Fab Inarsna ala034029
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
PHONE (904) 247-5855
Cashier Id: atlbcld\atibbja
Receipt Date: 6/7/2016 2:37:03 PM
Receipt Number: 0S-70048
• Job ID: 16-PLBG-1262 - PLUMBING - REPAIR IN
GARAGE PDBPR - State PLMG DBPR Surcharge
$2.00
Job ID: 1G-PLBG-1262 - PLUMBING - REPAIR IN
GARAGE PDCA - State PLMG DCA Surcharge $
2.00
Job ID: 16-PLBG-1262 - PLUMBING - REPAIR IN
GARAGE PL1 - Plumbing Fixtures $7.00
Job ID: 16-PLBG-1262 - PLUMBINGG - REPAIR IN
GARAGE TP - Trade Permit Base Fee $55.00
Amount Due: $66.00
Tender Information: Cash $66.00
Tender Type: CC
Tender Amount: $66.00
Change Due: $0.00