364 6th St plbg permit 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
30B INFORMATION:
Job lD: 16-PLBG-2080
Job Type: PLUMBING ONLY
Description: PLUMBING - 4 FIXTURES
Estimated Value:
Issue Date: 9/16/2016
Expiration Date: 3/15/2017
PROPERTY ADDRESS:
Address: 364 6TH ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: WAYNE CONN PLUMBING INC.
,CFC1428564
Address: 6915 W BEAVER ST
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $28.00
Trade Permit Base Fee $55.00
Total Payments: $87.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845
f
JOB ADDRESS: PERMIT#� � — I (O -r LBC - ZCJ�n
NEW OR REPLACEMENT INSTALLATION: Project Value$ _
TYPE OFFixTuRE QTY TYPEoFFi TuRE Qr)'
Bathtub Septic Tank&Pit
sh
Clothes Waer Shower _
Dishwasher �_ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs 7JV Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray T Water Connected Appliances
Lavatory Water Heater
Other FixturesjM Water Treating System
RE-PIPE:
TYPE oFF7xTURE QTY TYPEoFFIXTuRE 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 ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
**SJRWD Well Completion Form. Completed font 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 mol give autJlQmy to violate the provisions of any other state or local law regulation construction or the performance of constriction.
Property Owners Name j0, Phone Number
Plumbing Company jrY 44P.d X01404 4 ! Office Phone,3 /�-2 Fax r�
Co. Address: �q (5 14 �CLIIlf.l- 2!'t 1 city JaxX State I Zip32254
License Holder(Print): .4 -1 State Certification/Registration#
Notarized St nat
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