1545 FRANCIS AVE PLUMBING PERMIT �� �4CITY OF ATLANTIC BEACH
s f 800 SEMINOLE ROAD
180
'..� r� ATLANTIC BEACH, FL 32233
J INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-1209
Job Type: PLUMBING ONLY
Description: PLUMBING - 3 FIXTURES
Estimated Value:
Issue Date: 5/25/2016
Expiration Date: 11/21/2016
PROPERTY ADDRESS:
Address: 1545 FRANCIS AVE
RE Number: 172284-0000
PROPERTY OWNER:
Name: LYLES, TOMMY & SHIRLEY, *
Address: 13925 HUNTERWOOD RD
GENERAL CONTRACTOR INFORMATION:
Name: ADVANTAGE PLUMBING
Address: 880 MAYPORT RD QA GREG GAUSE
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: $80.00
PFRMMrr IS APPROVED ONLY IN ACCORDANCE WPrll ALL CITY OF ATLANTIC BEAC11 ORDINANCES AND THE FLORIDA
BUILDING CODES.
OW Jeminoie Ito Atlantic tseacn, r L. zzi
Ph(904)247-5826 Fax(904)247-5845 (o – p g , _ I Z
JOB ADDRESS: /6 -I5 ,A,7,4 ,1,,5 PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer _I — Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet J
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory ___i___ 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:
o Sewer Replacement ❑ Back Flow Preventer 0 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.**
O Other
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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 71,09 )Qb ,S Phone Number
Plumbing Company 44,y,4;9re_- otak rriiej Office Phone c'2-1Y- 9'`/- Fax 01Y7-9,A? ?J
Co. Address: g50 D � City 472 /3417 State , ` Zip s I
License Holder(Print): ,/ State Ce ificatioilt,..gistration# iii/ 696 ?
Notarized Signature of License Holier '�D (.1,,/ (,__
Sworn and subscribe wn' - . is dl l s ay of 20 I
C2
ID
TONT GINOLESPERGER afore of Notary Public � ....---
,T.
MY COMMISSION#'FF 924951
EXPIRES:October 6,2019
1•!RL... Bonded Thru Notary Pubic Underwriters