720 Triton Rd plbg permit dti CITY OF ATLANTIC BEACH
800 SErvHNOLE 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-1950
Job Type: PLUMBING ONLY
Description: replace tub, washer, dish washer, sink, shower pan, toilet,
water heater, sewer replacement
Estimated Value:
Issue Date: 8/26/2016
Expiration Date: 2/22/2017
PROPERTY ADDRESS:
Address: 720 TRITON RD
RE Number: 171338-0000
PROPERTY OWNER:
Name: PRODANOFF, GEORGE GOSPODINOV
Address: 445 W 1ST ST
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $49.00
Trade Permit Base Fee $55.00
Total Payments: $108.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
• 800 Seminole Rd Atlantic Beach,FL 32233
1 Ph(904)247-5826 Fax(904)247-5845
,TOB ADDRESS: I�rdo TfAmi RJ11 A+e"4ic PwJ R3az35 MIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE of FIXTURE QTY TYPE oFFLYTuRE QTY
Bathtub V 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 Z Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater JL
Other Fixtures Water Treating System
RE-PIPE:
TYPE or,FixTuRE QTY TYPE of F/xTURE QTY
Bathtub Septic Tank&Ph
Clothes Washer Shower
Dishwasher - Shower Pan
• Drinking Fountain Slop Sink
Floor Drain Thee 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
M;SCELLANEOUS:
Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
** VRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other
Permit becomes void if work does not c'ommrnce 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 of//her state or local law regulation/coqnswction or the performance of construction.
Property Owners Name Ged9w � ZOFYIItZ2 PYYI�Gt/YGOLfPhoneNumbe[ MO 3,9 .2713
Plumbing Company O cA)n 2!- CLU de r- Office Phone Fax
Co.Address: City State_Zip
License Holder(Print): rV � PIA/ tate Certification/Registration#
,r,tarized Signature of License Bolder
""'•i 4dg1l MY CORUsaoonRJI f�z+mtt Sworn and subscribed be o me this day of asfi 20�'
+ EXPIRES:Nmgual],2719
x;R;;y'+' m�a.a mrymadrrae¢mwv.rmn Signature of Notary Public - t/)d.�la:,._