593 Timber Bridge Ln 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-2243
Job Type: PLUMBING ONLY
Description: PLUMBING -WATER TREATMENT
Estimated Value:
Issue Date: 10/4/2016
Expiration Date: 4/2/2017
PROPERTY ADDRESS:
Address: 593 TIMBER BRIDGE LN
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: AFFORDABLE WATERMINDER INC
,JAX SPEC W-32
Address: 3760 KORI RD SPECIALTY WATER (CONS TDS OB)
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $7.00
Trade Permit Base Fee $55.00
Total Payments: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 _a
Ph(904)247-5826 Fax(904)247-5845 Co �j-2a43
JOB ADDRESS: 593 TlinbE& J34 e Lane A7LAWILBCd PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ (0(x•00
TYPE oFFIRTURE QTY TYPE oFFIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Slop Sink
Florna Fountain T�Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Trey Water Connected Appliances
Lavatory Water Heater
Other.Fixtures Water Treating System
RE-PIPE:
TYPE oFFIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Dram Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink — Vacuum Breakers
Lanni,TmyWater Connected Appliances
Lavatory Water Heater _
Other Fixtures Water Treating System _
MISCELLANEOUS:
o Sewer Replacement o Back Flow Preventer o Grease Interceptor(Trap)_gallons(Requires 3 sets of plow)
o Lawn Sprinkler System-Number of Heads ❑ Well yk ' tion.**
**SIRWD Well Completion Form. Completed be submitted form to to the Building Department for feast inspection."
r❑ Other
Penni[becomes void if work does not commence within a six month period or work is suspended or abmrdoned rer six months.I hereby certify then I have read
this application and know the areae to be nue and connect All Provisions of laws said ordinatum governing this work will be complied with whether specified
m rot The permit does not give authority or violate the provisions of any other slate or local law resolution cons[maion or the pain ;�ofconstru 829
Property Owners Name G e cog G e TONED Phone Number
Plumbing Company AFFO g DA to LE WA7£2 Office Phon?o�r.2-0197 FaxFax o Z
Co. Address: 3 7GO K O R i ROAD City J%cKsonti jje _ State RL Zip 3225
License Holder(Print): A S to Certification/Registration# W0818 G
Notarized Signature ojLi w Id
r NotaryacaYYMFIdMa
Sworn and subscribed bef �(o
a this 7'`l day of Sepreht sE2 20
Damlhy M Dawre
� ) u,comm»w,ea esax, Signature of Notary P tic
a/ a�v.•auarson