81 5TH ST PLBG PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
` ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
IOBINFORMATION:
Job ID: 16-PLBG-1352
Job Type: PLUMBING ONLY
Description: BATHROOM AND KITCHEN FICTURES-32 FIXTURES TOTAL
Estimated Value: $2,450.00
Issue Date: 6/13/2016
Expiration Date: 12/10/2016
PROPERTY ADDRESS:
Address: 81 5TH ST
RE Number: 170151-0000
PROPERTY OWNER:
Name: HOLMES, HARRIET E
Address: 81 5TH ST
GENERAL CONTRACTOR INFORMATION:
Name: B & G PLUMBING CO., INC.
Address: 2232 CORPORATE SQUARE BLVD QA GENE CHRISTIAN
ROVER
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $224.00
Trade Permit Base Fee $55.00
Total Payments: $283.00
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
TOBADDRESS: $ � 5th $f PERMIT# I5-RADb-Z3b3
14E OR REPLACEMENT INSTALLATION: Project Value%
a
TYPE oFFDII'URE QTY TYPE oFFncruRE QTY
Bathtub I Septic Tank&Pit
Clothes Washer 2 Shown. 3_
Dishwasher I Showa Pan
Drinking Fountain — Slop Sink
Floor Drain TThrre 1 Compartment Sink �—
Floor Sink
Hose Bibs _� Urinal
Kitchen Sink S Vacuum Breakers —
Laundry Tray l Water Connected Appliances 2-
Lavatory
Lavatory 5 Water Heater I
Other Fixtrrres Watch Treating System
RE-PIPE:
TYPE oFFIXTURE QTY TYPE'oFFltrvRE QTY
Bathtub Septi:Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Dountarn ThSlom,Sink
Floor
Compartment Sink
Floor Sink Toilet
Hose Bibs Uriml
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
Permit becomes void if work does not wmmenm within a six month period or work is suspesided or abandoned for six months.I hereby certify that I hayorra
this application and know the same to betme and warect. All provisions of laws end ordirances governing this work will be complied with whether specified
treat The permit does not give authority W violate theprovisiws of my other state or tonal law regulation wnshuction or the performanw of construction.
Property Owners Name N A d W-' Sg b a ti e k Phone Number
Plumbing Company k & 16T i 14 M bih q Co _Office Phone 223-35 85 Fax 22-3-3750
Co. Address: 22175-- <ovpovet Sc� �Ivd /1 " City Tgcktonville State- Zip 32-I-Ib
License Holder(Print): G eh e, C - V oy e k ,::, l ertificatio / �tlo
FCCD22'5g3Notarized Signature o,j L`ecerese folder ( () 1�JJ�U//LLf/`"'11 IAK���, �•�
.n'% av coAYMMaKwUUMMIS>e+t worn and subscribed before me this 1/13TM day of :5.. 20 16
i
EXPIRES.August 7,22M9 N I1J OD
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