1829 Atlantic Beach Dr plbg permit .j I�Lyr
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
706 INFORMATION:
lob ID: 16-PLBG-2407
lob Type: PLUMBING ONLY
Description: install 26 new fixtures
Estimated Value:
Issue Date: 10/26/2016
Expiration Date: 4/24/2017
PROPERTY ADDRESS:
Address: 1829 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: DARLEYS PLUMBING INC.
,CFC056702
Address: 4472 PHILLIPS HWY CA CARL LESLIE DARLEY
Phone: -
FEES:
Plumbing Fixtures $182.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $241.00
PERMIT LN APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 -
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: I O 2li 'rtu/ Qn PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPEOFFtxTURE QTY TYPE oFF/XTTIRE QTY
Bathtub Septic Tank&Pit
Clothes Washer J— Shower J_
Dishwasher �_ Shower Pan
Drinking Fountain Slop Sink
Floor Thain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen SinkJ— Vacuum Breakers
Laundry Tray I Water Connected Appliances Z
Lavatory G Water Heater I
Other Fixtures Water Treating System I
RE-PIPE:
TYPEOFFtavRE QTY TYPE oFFLYroRE 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.**
Cl Other
Permit becomes void if work does not commrnce 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 authority to violate the provisions of my other stare or local law regulation construction or the performance of columniation.
Property Owners arae I ot_� „A,.> Phone Number
Plumbing Company Office Phone lVfLf Fax2L aa-I YE&^
Co.Address: City— tate.'&_Zip, — _4
License Holder(Print): State Certification/Registration# CEC()5_r�
of F S' o License Holder
JOANNE MEHI Sworn and subscribed be oreI�Il.a this�z fTN da of �rolN-� 20/G
e: Notary Public State of 1781Flori � �9VY y
Commission GG 021281
My Comm.Eaplrn Aug 29,2029 Signature of Notary Public
Q� adult though National Way assn.