1941 Seminole Rd 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
JOB INFORMATION:
Job ID: 16-PLBG-2112
Job Type: PLUMBING ONLY
Description: PLUMBING - 14 FIXTURES
Estimated Value: $3,499.00
Issue Date: 9/21/2016
Expiration Date: 3/20/2017
PROPERTY ADDRESS:
Address: 1941 SEMINOLE RD
RE Number: 169542-0520
PROPERTY OWNER:
Name: LUCAS, DAVID 0
Address: 1941 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: PROFESSOR PLUMB
Address: 1015 ATLANTIC BLVD APT 247
Phone: 904-270-2266
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Plumbing Fixtures $98.00
Total Payments: $157.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TRE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
lqqlPh(904)247-5826 Fax(904)247-5845 1 C,_ PLg6_Z ( (Z
JOB ADDRESS: , t o;py l e �d/ PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ 5`(g tjb,-
TYPE oFFIXTURE 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
RE-PIPE:
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TYPE oFFIXTURE QTY "' TYPEOFFIXTURE QTY
Bathtub 'f. Septic Tank&Pit
Clothes Washer Shower
Dishwasher t Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet i
Hose Bibs �— Urinal
Kitchen Sink Jr Vacuum Breakers
Laundry Tray / Water Connected Appliances
Lavatory Water Heater J—
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 **
**SIRWD Well Completions Form. Completed(form to be submitted to the Building Department for final inspection.**
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 coma All provisions of laws and ordinances governing this work will be complied with whether specified
or not The permit does not give authority m violate the provisions of any other state or local law regulation construction or the performance ofconstrction.
Property Owners Name \/R�t(k (—UOA S Phone Number 38Z- 9( Z I
Plumbing Company r`a 4l s coy( gPhj r/r. b -$air_. Office PAhone 770 - 2 4 4 Fax
Co. Address: JD/5 /�/-LA.vr77't �/uel ff city Ad- Statea-, Zip ZZ
License Holder(Print): ERNES'f 1'1- fG�TI Stata Certification/Registration VZ 7,P 7,7i
Notarized Signature of License Holder
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