576 Coastal Oak Ln plbg permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
�". ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
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PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-2356
Job Type: PLUMBING ONLY
Description: install dishwasher, 2 hose bibs, sink, laundry tray, 4
lavatories, 2 showers, 4 toilets, water connected appliance, water heater
Estimated Value: $10,000.00
Issue Date: 10/19/2016
Expiration Date: 4/17/2017
PROPERTY ADDRESS:
Address: 576 COASTAL OAK LN
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: SWEENEY REMODELING AND PLUMBING
Russel Marvin Sweeney,Jr.,CFC1428337
Address: 14047 Mt Pleasant RD
Phone: 904-803-6437
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $119.00
Trade Permit Base Fee $55.00
Total Payments: $178.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
/ Ph(904)2247-5826 Fax(904)247-5845 Ib—fL BCSb
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JoB ADDREss: 6� .6 ('[�rti.Ski }- , PERMIT# [b
NEW OR REPLACEMENT INSTALLATION: Project Value$ dmry
TYPE OFFfXTURE QTY TYPE OFFLYTf/RE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower Z
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 OFFIXTORE QTY TYPE OF FIXTORE 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 **
**S/RWD 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.1 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 authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name :Z t A.1 a [n Phone Number %Q $D 3 F,L(-5-7
Plumbing Company w Ltidd& yt� &P-d �uokl;u Office Phone fSh4 T7 Fax
Co.Address: I4w-1 Al ea( J �.d �P City acK otl { State�/- Zip,L2724�—
License Holder(Print): Srs( IkA . u- St " Ication/Registration# L7�{/fly 37
Notarized Signature oi,License Holdel ,
TIMOTHY KELLY Before 7mhis_A day of 201
112
Commission 0 FF925374Ez Fa 7,2020 Signature of Notary Public.ni BMJrMigf*Iu1�raailAtl