340 8th St plbg permit �1
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
N� ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
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PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMATION:
Job ID: 16-PLBG-2845
Job Type: PLUMBING ONLY
Description: PLUMBING - 21 FIXTURES
Estimated Value: $6,000.00
Issue Date: 12/20/2016
Expiration Date: 6/18/2017
PROPERTY ADDRESS:
Address: 340 8TH ST
RE Number: 169928-0000
PROPERTY OWNER:
Name: Sifakis, Alex
Address:
GENERAL CONTRACTOR INFORMATION:
Name: CANNON PLUMBING, INC.
Olin M.Cannon,CFC1426140
Address: 1794 -1002 ROGERO RD QA OLIN MARSHALL
CANNON
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $147.00
Trade Permit Base Fee $55.00
Total Payments: $206.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION k-5P "L-7-76
CITY OF ATLANTIC BEACH
$00 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 6- PLSQ- Z 64S
JOB AAAREss: 2 +0 im S+ PERMIT'#
NEW OR REPLACEMENT INSTALLATION: Project Value S 6 Oft, ai`
TYP£nFFrXTUR£ QTY TYP£OFFIXTURE QTY
Bathtub X Septic Tank&Pit _
Clothes Washer I Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs I Urinal
Kitchen Sink t Vacuum Breakers
Laundry TrayLavWitter Connected Appliances
Water Heater
Otho Fixtures Water Treating System
RE-PIPE: /U
TYPE of FJXTUR£ QTY TYPE oFFTXTUR£ QTY
Bathtub Septic Tank&PR
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain SlopSink
Floor Drain The 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:
o Sewer Replacement o Back F1ow Prevemcr ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
o Lawn Sprinkler System-Number of Pleads ❑ Well ••
"•SJRWD Well Completion Form. Completes o�be submitted to t epi IB dig Department for final inspection.*"
❑ Other
Permit becomes void If work does not commence within a six march period or work is suspended or abandoned for six monthsl hereby ceNQ 16n f have read
this application and know tho same to be nue and correct. All provisions of laws and ordinances governing this work will be compiled with whether specifled
or not. The permit does not give authority to violate the provisions of say other state or local law regulation construction or the performance ofconstruaim.
Property Owners Name Si- ak're)4 Phone Number 9D4-39G- t^tSS
Plumbing Company Gan Dgn 9)� 'n4- Offs Phone 904-74f-0S'0 Fax f p.i_ Ss!-aµ1L
Co- Address: G,,,,rf,h 5+ City JaOCionv,lle� StateF4, Zip Z A
License holder(Print): or i n (A n no t1 State Certifiestion/Registration# GPL!°!'J-dl r X
r
Notarized Signature of License Holder
Myq'r� LESUEOALE Swom and subscribed before me this day of tern 6v 204
wkY Commkslane FFtd4s22
Expires July 20,2018
awa.+axnwra W...aos¢ms Siguanrrc of Notary Public S10- Z'kl—
CITY OF ATLANTIC BEACH
BBD SEMINOLE RD
CITY OF ATLANTIC BEACH
ATLANTIC BEAC,R.32233 800 SEMINOLE ROA
1220�2016 14:12:21 PTLflNTIC BEACH, FL
32233
CREDIT CARD PROW (904) 247-5926
VISASALE Cashier Id: atlbcld\atlbbja
Card# YJCO�X%pW0(902fi Receipt Date: 12/202016 2:16:04 PM
Receipt NuTar: OS-72020
SEQ#: 5 Job ID: 16-PLBG-2845 - PLUMBING - 21 FIXTUP
Batch#: 295 ES PDBPR - State PLMG DBPR Surcharge $2.0
INVOICE 5 0
AMoval Code: 020862 Joh ID: 16-PLBG-2845 - PLUMBING - 21 FIXTUA
5P MeW Malswl ES PDEP - State ?LNG OCP Surcharge $2.00
Nodi. 01" Job ID: 16-PLBG-2945 - PLUMBING - 21 FIXTUA
Tax kwt: $0AB ES PLI - Plumbing Fixtures $147.00
Card Coda: M
Joh ID: 16-deBG-2645 - PLUMBING - 21 FIXTU2
ES TP - Trade Pernit BaseseFee 1155.00
SALE AMOUNT $206,00 sant Dee: $206.00
Tender Info oration: Cash $206.00
Tender Type: CC
Tender Flnount: $2O6.00
CUSTOMER COW Change Due: $0.00