701 Beach Ave #204 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
JOBINFORMATION:
Job ID: 16-PLBG-2297
Job Type: PLUMBING ONLY
Description: install tub, sink, shower pan, toilet, water heater, water
treating system
Estimated Value:
Issue Date: 10/13/2016
Expiration Date: 4/11/2017
PROPERTY ADDRESS:
Address: 701 BEACH AVE 204
RE Number: 170237-0716
PROPERTY OWNER:
Name: VERMILLION TST,CHARLES & SALLY,
Address: 704 BEACH AVEAPT204 704BEACHAVE #204
GENERAL CONTRACTOR INFORMATION:
Name: KIMBALL PLUMBING, INC.
Mark Edward Kimball,CFC057897
Address: 12024 SUINOWA SPRINGS TR QA MARK EDWARD
KIMBALL
Phone:
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $42.00
Trade Permit Base Fee $55.00
Total Payments: $101.00
PERAHT IS "PROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Apr 06 03 04:08a Kimball Plumbing 904-7867235 P.1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BFACR
soll seminctire Rd Athintic Beach,Fl,32231
Ph(904)247-5826 Fax(go4),247,5845 1(0- f)L 66,—QQ91�t
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IOB ADI)IMSS. ----------
NEW OR REPLACEMENT INSTALLATION: Project Value$—
TypE op FIXTURE QTY TYPSOFFIXTUPE QTY
Septic Took&Pit
Bathtub Shower —
Clothes Washer shower Pan -4—
Dishwasher slop Sink —
DirilkirkgfOunmiR Three Compartment Sin,
Floor Drain Toilet
Floor Sink Urinal
HoseBibs Vacuum Broakm
Kitchen Sink Water Connected Applis cost
Laundry Tray Water Heater
Lavatory watcrTreatingsYstem
otherflixtures
R&PIPE:TYPE OF FIXTUnE TYPEOFFUME QTY
Bathtub Sell Tank&Pit —
clothes Washer Shower —
Dishwasher Shower Pan —
Slop Sink —
Drinking Fountain Three Compartment Sin, —
Floor Drain Toilet —
Floor Sink Urinal —
Hose Bibs vactrum Breal —
Kitchen Sink Water Connected Applia tocts
Laundry Tniy Waterlicatef
Lavalo-q Water Treating System
OtherFixtureg
MISCELLANEOUS: tease hul(Trap)_ gallons(Requires 3 nets of plaw)
l2S,wmR,phccment 0 Back Flow Preventer 110
u Lawn Sprinkler System-Nurnber of Heads-To— El Well----- -
**&IRWD Well Completion Form.Completed nn to be submitted to the BuilTing D partmeld for final insPectiOfL**
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License Holder(Trint): �A oL v 16,94 t a t,Cc rt i fi c all o n Re g i a trat i on AC66
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1011312016 CEDIT CARD
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CITY OF ATLANTIC BEACH
800 SENINDLE ROAD
ATLANTIC BEACH, FL 32233
PHONE (904) 247-SBK
Cashier Id: atlbcld\atlbbja
Receipt Date: 1011312016 8:35:52 AM
Receipt Number: OS-71477
Job ID: 16-fLM-2297 - install tub, sink, 3
hower pan, toilet, water heater, water trea
ting system PDBPR - State PLMG M Surchar
ge $2.00
Job ID: 1G-PLBG-2297 - i ristall tub, ai 4, 5
hower pan, toilet, wter heater, water treas
ting system PDCA - State PLMG DCA Surcharge
$2.00
Job ID: 16-PLBG-Z297 - install tub, sink, s
hisser pan, toilet, water heater, uater trea
tiN system PLl - Plumbing Fixtures $42.0
0
Job ID: 16-PLEG-2297 - install tub, sink, a
hower pan, toilet, water heater, �ter trea
tiR system TP - Trade Permit Base Fee $5
S.
Amount Due: $101.00
Tender Information: Cash $101.
Tender Type: CC
Terib,, Amount: $101.00
Change Due: $0.00