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235 N Oceanforest Dr plbg permit CITY OF ATLANTIC BEACH 800 SENHNOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-PLBG-2834 Job Type: PLUMBING ONLY Description: install/repair tub, 2 lavatories, 2 toilets Estimated Value: Issue Date: 12/19/2016 Expiration Date: 6/17/2017 PROPERTY ADDRESS: Address: 235 N OCEANFOREST DR RE Number: 169463-0090 PROPERTY OWNER: Name: Khadivi, Kyle Address: 235 Oceanforest DR GENERAL CONTRACTOR INFORMATION: Name: KELLEY'S PLUMBING CONTRACTING ,RF11067509 Address: 3866 VALENCIA RD MICHAEL RYAN KELLEY Phone: - FEES: Plumbing Fixtures $35.00 State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Trade Permit Base Fee $55.00 Total Payments: $94.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904)247-5826 Fax(904)247-5845 b- PLEtzi- a83y JOBADDRESS: 2>4�- JCt'Arp�>-,V '4—A7 PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value$ - TYPEOFFLYTURE QTY TYPE oFFDavRE QTY Bathtub —L 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 RE-PIPE: TYPE oFFIXTORE QTY TYPEoFFixTOBE 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 Tiny 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.** o 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 governing this work will be complied with whether specified or not The permit does not give authority to violate the provisions of any other slate or local law regulation construction or the performance of construction. Property Owners Name /r—J '�jy l Phone Number Plumbing Company KC/.tEV$ 1�(u^ r�i,4.� Cd,,-,9PObti I,)C Office Phone Fax Co.Address: 38(A-p shkwryL 70-� �6- City Jn k State FL Zip 3ZZO'S' License Holder(Print): miu ! kZ-Zw'if State 'flcation/Registmtion# Older t,�„�+, JBINIFERJbHNSTON nh aTM�"r^s�ONr� 21 _1 FgRWEB:Iktoler T!,NZ10 Before methis1 dayof D&L vy) bB-r 20 M BptlitltlT1NN0bry�` � Signature of Notary Public U u V Q�-