The URL can be used to link to this page

1432 Camelia St plbg permit $IyLyrj i CITY OF ATLANTIC BEACH j 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-2195 Job Type: PLUMBING ONLY Description: repair well, connect water service to city water meter off well Estimated Value: Issue Date: 9/29/2016 Expiration Date: 3/28/2017 PROPERTY ADDRESS: Address: 1432 CAMELIA ST RE Number: 171079-0040 PROPERTY OWNER: Name: CAMELLIA STREET PROPERTIES LLC Address: POST OFFICE BOX 28130 GENERAL CONTRACTOR INFORMATION: Name: MOON PLUMBING John R. Moon,Jr.,CFC019200 Address: 1103 PALM CIR QA JOHN ROBERT MOON 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: $73.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904)247-58216 Fax(904)247-5845 !b-p"Lll-a k olr JOB ADDRESS: zg3y (re PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE OFF/XTURE QTY TYPE oFFixTURE 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: TYPE oFFixTuRE QTY TYPE oFF7XTORE 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 D Back Flow Preventer D Grease Interceptor(Trap) ,,.g/allons(Requires 3 sets of plans) D Lawn Sprinkler System-Number of Heads Well 0r/( (�jry(' 4%^% **SIRWD Well Completion Form. Completed form to be submitted to the Building D_ep-aruneent�for finallins/pection.** [trUther e°S'^ .� /.J¢.�Or ajry '{zl �y-tee.."�'Jar Akf/' 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 some to be we and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give autt�o violate the provisions of any other state or local law regulation consmation or the performance ofconstructionn.. 16 Property Owners Name //��G� 0 V Jam- "N I T Phone Number Plumbing Company PI`-' N Wk, Office Phone 2,9FV, Fax Co. Address: 0 3, All,µ City State Oe'L-Zip 3 Z-Z v i License Holder(Print): State Certification/Registmtion# Cf1<.0/11077 Notarized Signature of License Holder ��..�/rr�� MY LOA MISSIetN raFF2n6at Before ethisday of �DTu�b°a- 20J,{� �,�` aP�mEww°uwt u' mmm Signature of Notary Public ati Gm-,—