168 SEMINOLE RD - PLUMBING I CITY OF ATLANTIC BEACH
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-J 800 SEMINOLE ROAD
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r ATLANTIC BEACH, FL 32233
J . INSPECTION PHONE LINE 247-5814
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PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-1669
Job Type: PLUMBING ONLY
Description: replace tub. lavatory, toilet
Estimated Value:
Issue Date: 7/25/2016
Expiration Date: 1/21/2017
PROPERTY ADDRESS:
Address: 168 SEMINOLE RD
RE Number: 170595-0000
PROPERTY OWNER:
Name: MCKNIGHT, W SCOTT
Address: 168 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: STEEG PLUMBING
Address: 1601 MAIN ST QA JAMES STEEG
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $21.00
Trade Permit Base Fee $55.00
Total Payments: $80.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 t0_ p L Q6n_ 1 lakVel
JOB ADDRESS: ) ' '
iY)'k g(9 PERMIT#
NEW OR REPLACEMEN INSTALLATION: Project Value$
' _ ; • IXTURE QTY TYPE OF FIXTURE QTY
Bathtub / Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain ToiletrCompartment Sink
Floor Sink
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory _f____ Water Heater
Other Fixtures Water Treating System
RE-PIPE:
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
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement 0 Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads 0 Well **
**SIRWD 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 ,AJVI 5dti Phone Number
Plumbing Company ��.! Cn ,rG Office Phone . %5V Fax
/� �% / r 7 State�� Zi z3
Co. Address: / / 1/A $( City ` ,6 Zip
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Holder(Print): " �� to Ce ification/Registration# . X37)g6
Notarized Signature of License Holder
Ali
V r7Otd atatx.ESPERGEER B.�ore me day `! c 20 i Y1-
4 ''1\-4r''' MI COMMISSION I FF 924951
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'°' 4 EXPIRES:October 6,2019
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