1091 HIBISCUS ST - PLUMBING CITY OF ATLANTIC BEACH
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-1754
Job Type: PLUMBING ONLY
Description: PLUMBING - 2 FIXTURE
Estimated Value:
Issue Date: 8/3/2016
Expiration Date: 1/30/2017
PROPERTY ADDRESS:
Address: 1091 HIBISCUS ST
RE Number: 171088-0116
PROPERTY OWNER:
Name: BISHOP, CATHLEEN M
Address: 530 GOLDENROD LA
GENERAL CONTRACTOR INFORMATION:
Name: EXPERT PLUMBING CONTRACTOR INC
Address: 7384 Hawks Cliff DR
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: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 /6 pLepc- _ /-754
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JOB
ADDRESS: /ec/" 1 1 ' ' ' i cei PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank&Pit
Clothes Washer Shower 4.—
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
RE-PIPE: 1.1
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:
o Sewer Replacement ❑ Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
o Lawn Sprinkler System-Number of Heads ❑ Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
o 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 £k f/ neva G ion/i44ao K LLC Phone Number
Plumbing Company Exfoirr P4446 iift.6 COring4(4�- Office Phone 0314)313-SSS'frax
Co. Address: 7-3gie 14M'[ Gi-H _ City JA-k' State FL Zip 3?2 2 Z
License Holder(Print): .. Q..( P1 l l 0-- S . - Certification/Registration#
Notarized Signature of License Holder �rtirn.a-- ii ,.
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jri i!' 11 MY COMMISSIONS FF 924951
„-..--,,,......z, EXPIRES:October 6,2019 ignature of Notary Public Si-, II
ICZ,:;„tiP Bonded Nu Notary Pubic Underwriters