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367 Belvedere 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 JOB INFORMATION: Job ID: 16-PLBG-2119 Job Type: PLUMBING ONLY Description: install tub, washer, sink, 2 lavatories, shower, 2 toilets, water heater Estimated Value: $1,700.00 Issue Date: 9/30/2016 Expiration Date: 3/29/2017 PROPERTY ADDRESS: Address: 367 BELVEDERE ST RE Number: 170703-0266 PROPERTY OWNER: Name: Mcpherson, John Address: GENERAL CONTRACTOR INFORMATION: Name: M &A PLUMBING INC Phillip O. Dennis,CFCG46207 Address: 1186 PECAN COVE KENNETH BRENNAN Phone: - FEES: State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Plumbing Fixtures $63.00 Trade Permit Base Fee $55.00 Work W/O Permit Plumbing $63.00 Total Payments: $185.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 09/21/2016 wet Sd: 111 FAX ®002/002A�� PLUMBING PERMIT APPLICATION �1�"l/� CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904)247-5926/ Fax(904)247-5845 l b-P�BC�/-a I lq JOH ADDRESS: S y /4P dere PERMIT# �"f Ire JI NEW OR REPLACEMENT INSTALLATION: Project Value$ . 7117EOFF7XTORE QTY TYPEOFFYXTURe 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 1— Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory �C Water Heater _L Other Fixtures Water Treating System RE-PIPE: TYPE oFFvavRE QTY TYPEOFR =RE 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 Prevemer Q Grosse Interceptor(Trap)_gallons(Requires 3 sets of plods) ❑ Lawn Sprinkler System-Number of Heads ❑ Well *0 **S/RWD Well Completion Form. Completrdtofm m be submitted to the Bulli g Department for final inspection.** ❑ Other Permit becomes void if work doss not conunaooe within a six monm period or work is suspended or abandoned for aid moaths.I hereby corli"a I have read this Application and know the same to be true and conrcL Al provisions of laws and ordkmces governing this work will be compiled with whether epaciHed m not The permh does not give autledty to violate the provisions of Any other sten:or local law regulation construction or the Warman ofwnnruceon. Property Owners Name �7'-44 Phone Number yq/.f69'�.3'/ Plumbink,,Q U� f un Office Phone 1y` Fax Co.A z�Ar 4 �1raX r� city State y Zip jz ) Lice`nse;I leer(Pr nt) d IIX�-W I5 State Certification/Registration# CFv"A YL2,o7 tom Y m.Eapk � Ntt�sriztd^S�s YLjeerf_e Holder d Np GG 23247 .� ` Swum ubscribed before me this day of \, C 20J ryr�9j� ,(/BLIG,.•P�p``�S Signature of Notary Pubh _S -ter J G"vL