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: $185.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
09/21/2016 wet Sd: 111 FAX ®002/002A��
PLUMBING PERMIT APPLICATION �1�"l/�
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5926/ Fax(904)247-5845 l b-P�BC�/-a I lq
JOH ADDRESS: S y /4P dere PERMIT# �"f
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NEW OR REPLACEMENT INSTALLATION: Project Value$ .
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
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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