1637 Beach Ave 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-2653
Job Type: PLUMBING ONLY
Description: PLUMBING - 5 FIXTURES
Estimated Value:
Issue Date: 11/29/2016
Expiration Date: 5/28/2017
PROPERTY ADDRESS:
Address: 1637 BEACH AVE
RE Number: 169652-0000
PROPERTY OWNER:
Name: ASHBY B/E, ELEANOR J, '
Address: 1637 -39 B BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: STYLES SMITH PLUMBING, INC
CFC041803
Address: 1537 PENMAN RD SUITE A QA DARRELL GLEN SMITH
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 )COn� p,�
Ph(904) 247-5826 Fax(904) 247-5845 J -PL6 _ Z 6153
JoB ADDREss: /617 -Sr c 41 Arc PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFixTURE QTY TYPE oFFIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan /
Drinking Fountain Stop 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: ✓) /1
TYPE oFFixTORE QTY ✓/ TYPE oFFixTORE 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 Tmy Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement D Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
** &IRWD 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.I hereby certify that I have read
this application and know the same to be true and correct. All provisions of laws and ordinances goveming 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 concoction or the performance of construction.
Property Owners Name ;roe Ek s .:rte - Phone Number
Plumbing Company S4/ I,Office Phone Z411— 131 Fax
Co. Address: /"7 Pew ✓ Rr< City Ti< ig�l. States'/. Zip zzse
License Holder(Print): State Certification/Registration# CFCoY/fe3
Notarized Si nature o License Holder
TONT GINOIE�PERGER �Z da Of
rnvcatinnlsslaNarRsza%I Before methis y
a' EX RIRE6:Odcber 6,m19
"'•2,iy„n.' mnxaraNNvwacume�am. Signature of Notary Public