1135 LINKSIDE CT W PLBG PERMITPLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
ri •.. 800 Seminole Rd Adantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845 I (o - P L f3(Sj- )Z (, 7 -
JOB
JOB ADDRE5s: 113 �- 1— r at- Sl A� (-A e+ Uleg+ PFn= # .
NEW OR REPLACEMENT INSTALLATION:
RE -PIPE:
TYPE OFFIXrURE
Bathtub
Clothes Washer
Dishwasher
Drinking Fountain
Floor Drain
Floor Sink
Hose Bibs
Kitchen Sink
Laundry Tray
Lavatory
Other Fixtures
TYP►OFF/XTURE
Bathtub
Clothes Washer
Dishwasher
Drinking Fountain
Floor Drain
Floor Sink
Hose Bibs
Kitchen Sink
Laundry Tray
Lavatory
Other Features
QTY
Project Value g
TYPEDFFIXTURE Q77
Septic Tank & Pit
Shower
Shower Pan
Slop Sink
Three Compartment Sink
Toilet
Urinal
Vacuum Breakers
Water Connected Appliances
Water Heater
- Water Treating System
err TYPEoFFixTURE
I Septic Tank & Pit
Shower
Shower Pan
Slop Sink
Three Compartment Sink
Toilet
Urinal
I Vacuum Breakers
Water Connected Appliances
Water Heater
Water Treating System
QTY
MISCELLANEOUS:
❑ Sewer Replacement D Back Flow Preventer ❑ Grease Interceptor (Trap) __ gallons (Requires, 3 sets of plans)
❑ Lawn Sprinkler System -Number of Heads ❑ Well **
** SJRWD Well Completion Form._ Completedorm to be submitted to ex Aepartment for final inspection."
❑Other_ 14k.n gArHa en.ira% -o A,a4 /,lnrh,rl nsa,'ae -&
Permit becomes void if work does not commence within a six month period or work is suspa led or abandoned for six months. 1 hereby onsfy that 1 have reed
this application end !WOw the same to be true and correct. All provisions of laws strut ordinances governing this work will be complied with whether specified
or ns, The permit d7 d not give authority m violate th,epnrovision; of any other a= or Wal law regulation wnavuction or the perfrmmnoe ofconsuoaion.
Property Owners Name L,ann
el Ir *4-c Phone Number, jy�-(py-fityt
Plumbing Company
Plwner%`f-1 *4-00Fax9a4-M-dtlL
Co.Address: hif (-. Mimi S -L City r` I�GoaVJ6 StateLZip3s.e't14
License Holder (Print): lZ l I'll ifan no ri State Certification/Registration # CfL 1q;4 I'(• %
No(orized Slgnatwre of License Holder
I.EgIIE nALE Sworn and subscribed before me this day. of �N^ G zo 6
Expn ssju n2 W 144327
Expaw •Nry 73, Tote Signature of Notary Public
e.+., m.,q rn mrww.w.eau*
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
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
rnone -
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
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At1ANTIC BEAC, 14'.36'.
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Cad 0 444
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pOSTOMER COPT
CITY OF ATLANTIC EACH
B00 SEMINOLE ROAD
ATLANTIC BEACNI FL 32233
P4DW (904) 297-5055
Cashier Id: atl6cld\atl66ja
Receipt Bate: 6/7,ld\a 2:37:03 PM
Receipt Number; pS-70048
GARAGE PBB� R 1262 - PLL4@INB - REPAIR
12 00 State PLMG DBPR Surcharge
JoWAGE b ID; 16=PLBG-1262 -PLUMBING -REPAIR
2.00 PPCA -State PLMG BCA Surcharge
Job ID: 16-PLBG-1262 - PLUMBING - REPAIR I
GARAGE PLI - Plumbing Fixtures 57.00
��E 1P-PLTG-1262 - PLUMBING - REPAIR II
ade Permit Base Fee 555.01
Amount Due: 166.00
Teller Tntm:matim; Cash 166.00
:Iun :
eller Amunt; 166,00
Lange Due: 10.00