398 Sherry Dr plbg permit s �t I.:Ly jr1
CITY OF ATLANTIC BEACH
s> 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5514
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMATION:
Job ID: 16-PLBG-2858
Job Type: PLUMBING ONLY
Description: install 21 fixtures
Estimated Value:
Issue Date: 12/22/2016
Expiration Date: 6/20/2017
PROPERTY ADDRESS:
Address: 398 SHERRY DR
RE Number: 170483-0000
PROPERTY OWNER:
Name: NEW ATLANTIC BUILDERS INC
address: 5875 MINING TER
GENERAL CONTRACTOR INFORMATION:
Name: HOFFMAN PLUMBING II INC.
,CFC1427126
Address: P O BOX 65058 P.O. BOX 65058
Phone: -
FEES:
Plumbing Fixtures $147.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $206.00
PERMrr IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORHIA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)24477-5826 Fax(904)247-5845 b-P L B 6) -
JoBADDREss: 390 Sherry I.r PERmrr#JG —SE -unr
NEW OR REPLACEMENT INSTALLATION: Project Value$ - -
TYPE oFFTXTURE QTY TYPE oFF=URE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower T
Dishwasher �_ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet L—
Hose Bibs 2. Urinal
Kitchen Sink = Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE QTY TYPE oFF=AE 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 o 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
Us application and know the same to be one 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 viol the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name H14r,-r1- go, Gt Phone Number
Plumbing Company Ai'L MArJ,J W M iX,A 6 (Z ),)c-, Office Phone Fax
Co. Address:2 0. rio e �rV S S City "6 A r State Y2 Zip 3).n(,
License Holder(Print): State Certification/Registration# Cit-1 q2-1 )Z 4
-',R older �f D
JENNIFER JOHNSTON J
corunssioNacoaxsa< Before me this 2
n+va day of LNl b&4 201 (0
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`•`�l••`j aoi°'""'"'"°"�"°�k an°`""'°" Signature of Notary Public \\�n`-Y.t