824 SHERRY DR - PLUMBING S: J
.. \s, CITY OF ATLANTIC BEACH
r
::, - 800 SEMINOLE ROAD
7, r 4a, N
ATLANTIC BEACH, FL 32233
7 _.,) INSPECTION PHONE LINE 247-5814
. J. W'r
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-1562
Job Type: PLUMBING ONLY
Description: PLUMBING - 7 FIXTURES
Estimated Value:
Issue Date: 7/12/2016
Expiration Date: 1/8/2017
PROPERTY ADDRESS:
Address: 824 SHERRY DR
RE Number: 170392-0000
PROPERTY OWNER:
Name: ANDERSON, TIMOTHY
Address: 824 SHERRY DR
GENERAL CONTRACTOR INFORMATION:
Name: SUNSHINE STATE PLUMBING
Address: 1340 TRAILWOOD DR MICHAEL TROY PORTER
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $49.00
Trade Permit Base Fee $55.00
Total Payments: $108.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC 13EAC11 ORDINANCES AND TIIE FLORIDA
IRIILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 n
Ph(904)247-5826 Fax (904) 247-5845 I ( `f"c - 1 560 7
JOB ADDRESS: 824 SHERRY DR PERMIT# 16-SFR-9.52
NEW OR REPLACEMENT INSTALLATION: Project Value$
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
Lavatory7--* Water Heater
Other Fixtures Water Treating System
RE-PIPE: 1
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 1
Hose Bibs Urinal
Kitchen Sink 2 . Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 2 Water Heater 1
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads 0 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 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 Timothy Anderson Phone Number
Plumbing Company Sunshine State Plumbing Office Phone 904-262-1066 Fax 904-262-0358
Co. Address: 710 Haines Street City Jacksonville State FL Zip 32202
License Holder(Print): Michael T. Porter
State Certification/Registration#CFC 1426859
Notarized Signature ofLicense Holder 11/fre7C_____
p11Y py9 Sworn and subscribed before m his a day of 1v 14) 20/L
4°Z.ti.•.e0 DAVINA R.DICKERSON
* * EXPIRES:
EX COMMISSION i3 FF 061309 Signature of Notary Public
ki PIRES:October 22,2017
err o Condeo Thru Budget Notary Services