145 Pine St plbg permit i�L`J y
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
706 INFORMATION:
Job ID: 17-PLBG-2932
.Job Type: PLUMBING ONLY
Description: install 2 lavatories, shower pan, toilet
Estimated Value:
Issue Date: 1/5/2017
Expiration Date: 7/4/2017
PROPERTY ADDRESS:
Address: 145 PINE ST
RE Number: 170635-0200
PROPERTY OWNER:
Name: WELLS ET AL, JOHN BENJAMIN
Address: 145 PINE ST 145 PINE ST
GENERAL CONTRACTOR INFORMATION:
Name: PIPE-RIGHT PLUMBING SVC INC
Carl David Hamm,RF11067554
Address: 1311 TROTTERS WALKWAY
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: $87.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
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Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: 5 / i/1 I —PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFixTURE QTY TYPEOFFDauRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower Z
Dishwasher Shower Pan
g Slop Sink
Floor Drain Fountain �e 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 oFFLYTURE QTY TYPE oFFIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
g SlopSink
FFountain 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:
❑ 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
Permit becomes void if work does not commence within a sot month period or work is suspended or abandoned for six months.I hereby cera£?that I have d
this application and know the same to be tme and correct. At provisions of laws and ordinances governing this work will be complied with whether specified
moot. The permit does not give authority tooviolate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name -5-12 11 -Ile 1 Phone Number
Plumbing Company Z,r G Office Phone 9� 66.E- y/�'a ✓Z
Co.Address: City 'Tor x State Zip U
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License Holder(Print): State Certification/Registration# r rG 7
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sncoaaissta+ec000as+ Before me this 5 dayof 0. t-lW` 20 l�"
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Bq°itlTMuNOyryPi°°`a'""""� Signature of Notary Public
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