74 Oceanside Dr plbg permit f�-1�Jry s
n CITY OF ATLANTIC BEACH
.i
800 SEMINOLE ROAD
u ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
r�D;S1J'
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-2236
Job Type: PLUMBING ONLY
Description: replace sink, lavatory
Estimated Value:
Issue Date: 10/4/2016
Expiration Date: 4/2/2017
PROPERTY ADDRESS:
Address: 74 OCEANSIDE DR
RE Number: 168846-5155
PROPERTY OWNER:
Name: Et, Alex Viera AL
Address:
GENERAL CONTRACTOR INFORMATION:
Name: COGBURN AND WAKEFIELD PLBG
,CFC1428140
Address: 5900 TOWNSEND BLVD APT 522 QA JOHN COGBURN
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: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS:
—7q OcP.A1rJSt Dry PERMIT#,—aa3b
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NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFIXTuRE QTY TYPE oFFLYTURE 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 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
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well `•
**SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other
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 correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give auNority to violate the p ov(is�ions Mn ether;at r`o(law regulation construction or the performance of construction.
Property OwnersName a7 02 / Iia S^c`uLX IJ[n C..11 n Phonc Number qa`I- zy1.G3Ln
Plumbing Company. Iwc.krua- M^) Office Phone 9W, SIX
Co.Address: gUI J TAL* City -1-dA State FL Zip 7Zzto
License Holder(Print): a (M C,,6.A-L State Certiftcation/Registration# (f P< 1`11 V I Va
No ll
older
" loll GING EP
"*�` av cw.nalsslGawFrsz<sst Before methi day 20
p = EXPIRES'.October 6.MIS
'.dill: BoneeArnrvtb'aY PUMsuneervAan
Signature of Notary Public