2011 Beach Ave - Plumbing 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-2412
Job Type: PLUMBING ONLY
Description: install 9 new fixtures
Estimated Value: $1,200.00
Issue Date: 10/26/2016
Expiration Date: 4/24/2017
PROPERTY ADDRESS:
Address: 2011 BEACH AVE
RE Number: 169707-0000
PROPERTY OWNER:
Name: BARNWELL, STANLEY L
Address: 21453 ROSEPARK CT
GENERAL CONTRACTOR INFORMATION:
Name: M &A PLUMBING INC
Phillip O. Dennis,CFC046207
Address: 1186 PECAN COVE KENNETH BRENNAN
Phone: -
FEES:
Plumbing Fixtures $63.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $120.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION D
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fm(904)247-5845
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IOB ADDRESS: aelal/ Ala/ 1AX- PERMIT#
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dEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFIXTORE QTY TYPE OF FIXTURE QTY
BathtubSeptic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Ihain
Thra Compartment Sink
Fluor Sink Toilet OF—
Hose Bibs Urinal
Kitchen Sink T Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory r� Water Heater
Other Fucmms Water Treating System
tE-PIPE:
TYPE oFFfXTORE 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
4ISCELLANEOUS:
I Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 Bets of plans)
i Lawn Sprinkler System-Number of Heads ❑ Well '*
*SIRWD Well Completion Form. Completed lormto be submitted to the Building Department for final inspection."
i Other
ennit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.l hereby certify out 1 have read
us application and know the same to be hue and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
r not. The permit does not give authority to violate the provisions of any other smte or local law regulation construction or the performance of construction.
'ropertyOwners Name `>/-✓./<' Phone Number
'Itunbin 111111 �d / ✓ntLgt 1
of Phone P7-7(L-o1V Fax
;o. Adtlret�;: city .J,rrllcw,rrl/v State Zip3-12e
Aceppeer State Certification/Registration#
✓ofaiized•,A141rolder O• -
N° �V•' Q: Sworn subscribed before me this a2(ate day of 0174Dbe r 20�
• PUBS.;• Q
' r':sTATE•OF S` Signature of Notary Public kom L.1A . -
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