371 8th St plbg 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
]OB INFORMATION:
Job ID: 16-PLBG-2492
Job Type: PLUMBING ONLY
Description: install sink, lavatory, shower, toilet
Estimated Value:
Issue Date: 11/7/2016
Expiration Date: 5/6/2017
PROPERTY ADDRESS:
Address: 371 STH ST
RE Number: 169975-0000
PROPERTY OWNER:
Name: WOOD, JEREMY B
Address: 371 8TH ST
GENERAL CONTRACTOR INFORMATION:
Name: TDG PLUMBING
,CFC1427062
Address: 4426 LOYS DR QA TRAVIS DALE GAINEY
Phone: -
FEES:
Plumbing Fixtures $28.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $87.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDMANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
�y^� QPh(904)247-5826 Fax(904)247-5845
JOB ADDRESS: J ! I CJ T� ` PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ -
TYPE oFFLYTURE QTY TYPE oFFIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet I
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE oFFIXTURE QTY TYPE oFFIXTURE 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
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other h`n` ail 2 ayo - napeoT SF1�yeP
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 hav 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 myotherstate or local law regulation commotion or the performance of construction.
Property Owners Name k) 4 C2wnW i O�l Phone Number
Plumbing Company 1 �J Office Phone �'y x'41 FaxZ-L.4-
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Co.Address: Cit zs A -� State ft- Zip
License Holder(Print): J` D (;,4 ,, A State Certification/Registration#
Ebolder rr
ti'+i^,);, omoanNaMmlre �j
MYCOMMISSIONRFF101513 Before me[his Is 20
.. :o' ExPIRE5:Mry11.]me cy"� /
^Cr'�'` mw.a tMa Nmay nmx�uaaanM. Signature of Notary Publi /-