1853 SEA OATS DR - PLUMBING 1-
,- 1.,i.v./: ,
jJS, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
Iiir: ATLANTIC BEACH, FL 32233
Jv~ INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-940
Job Type: PLUMBING ONLY
Description: 8 FIXTURES
Estimated Value:
Issue Date: 5/11/2016
Expiration Date: 11/7/2016
PROPERTY ADDRESS:
Address: 1853 SEA OATS DR
RE Number: 172020-0542
PROPERTY OWNER:
Name: LYON, MARIA J
Address: 108 TROON POINT LN
GENERAL CONTRACTOR INFORMATION:
Name: HARRY L HAYES PLUMBING INC
Address: 6837 OAKWOOD DR HARRY L HAYES
Phone: - -
FEES:
Trade Permit Base Fee $55.00
IState PLMG DCA Surcharge $2.00
State PLMG DBPR Surcharge $2.00
0
Plumbing Fixtures $56.00
4
Total Payments: $115.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
1
I
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax(904)247-5845
i -tZAP, CZ--
JOB ADDRESS: t 5 J C c}"S T.)c PERMIT# 1 2
NEW OR REPLACEMENT INSTALLATION: Project Value S
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Z. Septic Tank& Pit
Clothes Washer Shower _IL_
Dishwasher Shower Pan _I__
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 2.
Hose Bibs Urinal
Kitchen Sink ____L___ Vacuum Breakers .
Laundry Tray Water Connected Appliances
Lavatory "Z. Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower AllE
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink ._ Vacuum Breakers -\
LaundryTray Water Connected Appliances
Lavtory y Water Heater ._co,
Other Fixtures Water Treating System
MISCELLANEOUS:
Sewer Replacement -2 Back Flow Preventer Ti Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
:_::: Lawn Sprinkler System-Number of Heads L; Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
Other
olommliollimlimillowlialmillomilammumisamomIlliolmillolluillloolloolmillmmaimmallmillmmil
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 1' 'l ck.r', cfx. n r Phone Number
Plumbing Company 1-t. c- r ..t< .�PS j71 ._....ASA:5 1,Nefftce Phone 123 5&- '1 Fax3z 9-'13 a S
Co. Address: 1 3 v 4,-\; 5k-�,. 5 -t, „-k-v., City J,.— State FF Zip ALL/f.,,
License Holder(Print): 1-4 �,r r, k--t-�_ ' State Certification/Registration # i' i 47-7O5
Nosts, ' •
1°.'Ytv.-1.
P ♦ A 20 )
(AURA HOWELL CREGER c y J
. lry Pubf •State of Florld0 orn and su scn ed before e this , /ftalrc '�C mmissi IFF 179131 Public `�
. ) r .•• 51y Co , .�l kes Nov 25.201$ a ature of Notary al/1
r