462 INLAND WAY - PLUMBING IA\fri
, -41 ' a ``te? CITY OF ATLANTIC BEACH
A r) 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-1395
Job Type: PLUMBING ONLY
Description: PLUMBING - 2 FIXTURES
Estimated Value: $800.00
Issue Date: 6/16/2016
Expiration Date: 12/13/2016
PROPERTY ADDRESS:
Address: 462 INLAND WAY
RE Number: 169463-1540
PROPERTY OWNER:
Name: HAMANN,CHRISTOPHER G & LISA R, *
Address: 462 INLAND WAY
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 $14.00
Trade Permit Base Fee $55.00
Total Payments: $73.00
PER`IFI' IS APPROVED ONLIIN ACCORDANCE 'WITII AI,I, CI-11' OF ATLAN IIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
. r\.,\JJ
(-----r) J,„' ''' \S CITY OF ATLANTIC BEACH
:,-Pr- ,;.‘:-., ._ 0 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
___y
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-1395
Job Type: PLUMBING ONLY
Description: PLUMBING - 2 FIXTURES
Estimated Value: $800.00
Issue Date: 6/16/2016
Expiration Date: 12/13/2016
PROPERTY ADDRESS:
Address: 462 INLAND WAY
RE Number: 169463-1540
PROPERTY OWNER:
Name: HAMANN,CHRISTOPHER G & LISA R. *
Address: 462 INLAND WAY
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 $14.00
Trade Permit Base Fee $55.00
Total Payments: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITII ALL CITY OF ATLANTIC BEACH ORDINANCES AND TILE FLORIDA
BUUI1,DING CODES.
r'' s,� ATLANTIC BEACH
r . PERMIT RECEIPT
,:,:.--/Te-rd,..
_______2
PERMIT DESCRIPTION: PLUMBING- 2 FIXTURES
PERMIT NUMBER: 16-PLBG-1395
ADDRESS:462 INLAND WAY (i.
OWNER:
DATE ISSUED:
FEES DUE:
State PLMG DBPR Surcharge $2.00
CITY OF ATLANTIC BEACH -
State PLMG DCA Surcharge $2.00 800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
06;1612016 15:38:23
Plumbing Fixtures $14.00 CREDIT CARD
VISA SALE
Trade Permit Base Fee $55.00 Card; XXXXXXXXXXXX9026
SEQ is 6
Batch#: 151
INVOICE 6
Totals: $73.00 Approval Code: 091
Entry Method:
Mode: Onli
Tax Amount: $0,00
Card Code: M
SALE AMOUNT $73.00
CUSTOMER COPY
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Pb (904) 247-5826 Fax (904) 247-5845 1 (6 -PC-8G `f j r-
JOB ADDRESS; , rh f an . 1 PERMIT#
NEW OR REPLACEMENT INSTA)<LATION: Project Value $ `r0r1I .c
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan V
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink 1 Vacuum Breakers — _
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures l Water Treating System
RE-PIPE: / Z
TYPE OFRATIITRE 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
Bose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
o Sewer Replacement 0 Back Flow Preventer - Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads o Well s*
>F* SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
t)kOther t/20ijr'e• 5,n)c in IC,-Fah,n l'S)Rr`� / J.0.111' (re 4 k;+a rLa-miohl_;
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 relul
this application and know the same to he 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.
II
Property Owners Name I li �. 1 Phone Number qt('-'3` /
Plumbing Company CaalnOA _94,.01., 1.,� Office Phone gVf.--24.2f- �3'CPS Fax %*-..S51-0.'tl(
Co. Address: I-7)S' E. CIii,r.k 54- City .incl.-Son✓,lle. State 1'_ Zip 17z02
License Holder(Print): 0 1)// C'l bvf`rp4`/ State Certification/Registration# C FG/13f.c24,l t d
Notarized Signature of License Holder c2)---____—_
4,'Pj LESLIE DALE Sworn and subscribed before me this I day r\--f 2O tie
? i., . Commission#FF 144322
*.:4 FA! Expires July 23,2018 Signature of Notary Public
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