60 ARDELLA RD - PLUMBING `� Ll\<1, CITY OF ATLANTIC BEACH
- •_ \s) 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-1664
Job Type: PLUMBING ONLY
Description: PLUMBING - 6 FITURES
Estimated Value:
Issue Date: 7/26/2016
Expiration Date: 1/22/2017
PROPERTY ADDRESS:
Address: 60 ARDELLA RD
RE Number: 172065-0000
PROPERTY OWNER:
Name: HAMIL JR, ROBERT M
Address: 60 ARDELLA RD
GENERAL CONTRACTOR INFORMATION:
Name: ST JOHNS PLUMBING
Address: 2260 S MARLEE RD QA ROBERT GEORGE WILSON
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $42.00
Trade Permit Base Fee $55.00
Total Payments: $101.00
1
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Jul 21 16 04:34p stjohns plumbing 904-287-4505 p.1
Jul 21 16 03:21p Mack Brothers (904)220-0520 p.1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845 i P L 8e-- 1
JOB ADDRESS: 60 Ardelta Rd. PERMTT# 16-CAAR-1566
NEW OR REPLACEMENT INSTALLATION: Project Value $ _
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
y
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain 1 Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 1
Hose Bibs _ 2 Urina
Kitchen Sink 1 -- Vacuum Breakers
Laundry Tray `Water Connected Appliances
Lavatory 1 Water Heater
Other Fixtures Water Treating System
1
RE-PIPE: LO
TYPE OF FIXTURE. en- ` TYPE'OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Silk Toilet
Hose Bibs _ Urinal
Kitchen Sink Vacuum Breakers _
Laundry Tray __ Water Connected Appliances __
Lavatory Water Heater
Other Fixtures Water Treating System
— —
MISCELLANEOUS:
D Sewer Replacement u Back Flow Preventer G Grease Interceptor(Trap)_ gallons(Requires 3 sets of plans)
o Lawn Sprinkler System-Number of Heads O Well I,*
**SJRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.**
0 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 ocdlnalces governing this work will be complied with whether specifled
or not. The permit does not give authority to violatc the provisions of any other state or local law mrlilation construction or the performance of construction.
Property Owners Name Dennis&Judith Leroux Phone Number 303-4350
Plumbing Company St. Johns Plumbing, Inc. Office Phone 705-5133 Fax 287-4505
Co.Address: 2260 Martee Rd. S. City Jacksonville State FL Zip 32259
License Holder(Print): Robert G. Wilson State Certification Registration* CFC056635
Notarized Signature of License Holder ~�
sworn and subscribed before m tis �/ day of .,1 v IL/ . 20 6
°es%''••, PAMELA HRYNCEW1CZ // /
M+ :._ 611'COMMISSION it FF 098164 Signature of Notary Pubi is rei2-0--,-el-c----;;.
~ 11"....' EXPIRES:March 4,2018
-..aa
'.''' Bonded Thr Notary Public Underwriters