1651 MAYPORT RD - PLUMBING CITY OF ATLANTIC BEACH
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800 SEMINOLE ROAD
J /_r 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-1967
Job Type: PLUMBING ONLY
Description: PLUMBING - 10 FIXTURES
Estimated Value:
Issue Date: 8/30/2016
Expiration Date: 2/26/2017
PROPERTY ADDRESS:
Address: 1651 MAYPORT RD
RE Number: 172072-0000
PROPERTY OWNER:
Name: CONSELICE JR ET AL, JOSEPH J
Address: 1651 MAYPORT RD
GENERAL CONTRACTOR INFORMATION:
Name: FOUR STAR PLUMBING COMPANY
, CFC056689
Address: 40 W 16TH ST QA ROBERT JAMES FLORNOY
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $70.00
Trade Permit Base Fee $55.00
Total Payments: $129.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
I
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 16- P(-3 -) 9 to /-7
o e+ re
JOB ADDRESS: / V � ' MAN( PD. PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub I Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
—I----
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet ___2..._
Hose Bibs 2. Urinal
Kitchen Sink —1-- Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Z ,7-----, -"Water Heater --I_
Other Fixtures \Water Treating System
RE-PIPE:
TYPE OF FIXTUREQT1
\ TYPE OF FIXTURE TY
Bathtub \......„-� QTY
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
1 MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
** SJRWD 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 ority to violate the provisions f any other state r local law regulation construction or the performance of construction.
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PropertyOwners Name O(1SC? t C 1 O ! - oneumper ,ve
1 3
Plumbing Company F014 g-- S 9LUJnI N 9 1../..x. Office Phone O4~35S-' Fax 1OY3353-3//9(
Co. Address: 1 Ule-S4- / 6 S / City j Et-)c, State P(- Zip ,3?2°4
License Holder (Print): 10b02.5}" C 13b1 State Certification/Registration#CFCo,s 4C '1
Notarized Signature of License Holder1.
.
TON1 GINDLESPERGER Be',re me this 29 da . ' • ,� 1 /
4:-Y.. is s IP'
v?' �- MY t;oMMISoION it FF 924951 � r
'',;i EXPIREs:OClober6.2e1�g ature of Notary Public Is tii _ I lb
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