1330 Ocean Boulevard plbg permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
:•'j ATLANTIC BEACH,FL 32233
- INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMATION:
Job ID: 16-PLBG-2476
Job Type: PLUMBING ONLY
Description: install new sink, other fixture
Estimated Value:
Issue Date: 11/4/2016
Expiration Date: 5/3/2017
PROPERTY ADDRESS:
Address: 1330 OCEAN BLVD
RE Number: 171847-0000
PROPERTY OWNER:
Name: PALEY, SEAN &ALICIA, '
Address: 1330 OCEAN BLVD
GENERAL CONTRACTOR INFORMATION:
Name: ADVANTAGE PLUMBING
Gregory K. Gause,CFC1425939
Address: 880 MAYPORT RD CIA GREG GAUSE
Phone: -
FEES:
Plumbing Fixtures $14.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: /336 41VJ1 -PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPEOFFamRE Q7T TYPE OFFLITURE Q7T
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan —
Drinking Fountain Slop Sink
Floor Sink
Floor Drain Three Comparnnent Sink
Hose Toilet Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
OtherFLavatouduresWater Heater
Water Treating System
RE-PIPE:
TYPE OFFlxmRE QTY TYPEOFFDUVAE Q7T
Bathtub Septic Tank&Pit
Clothes Washer Shower —
Dishwasher Shower Pan
Door Dr Fountain Slop Sink
Floor Drain Three Compartment Sink
HosFloor Sink Toilet
Kitchen
S Urinal
Kitchen Sink Vacuum Breakers _
Laundry Trey 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 ++
**SJRWD Well COmpletion Form. Completed fomt to be submitted to the Building Department for final inspection.**
❑ Other
Permit becomes void if work does not commence within a sic 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 one and cancer. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give authorityto violate the prevision of any other state or local law mgulation constmction or the performance of construction.
Property Owners Name , IJ 1 Phone Number
Plumbing Company ) OfficePhonec2Y'�- '?RV6r Faxa2Z2- qtW
Co.Address: f�8 o m a 1 �a City ML 8r� State zip3:�33
License Holder(Print): -� State Certification/Registration#PFC1�{"2
Notarized Signature of License Holder o t,I. � -
p.+3:6;k,: sENwfEa taHHsUT
me t rs 1 day of t�00-n bt-( 20 1 tO
MY COMMISSIQY M re of No Public 0 a�'
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