379 Royal Palms Dr plbg permit CITY OF ATLANTIC BEACH
f
800 SEMINOLE 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-2887
Job Type: PLUMBING ONLY
Description: PLUMBING - 12 FIXTURES
Estimated Value:
Issue Date: 12/29/2016
Expiration Date: 6/27/2017
PROPERTY ADDRESS:
Address: 379 ROYAL PALMS DR
RE Number: 171491-0000
PROPERTY OWNER:
Name: AURE, EUDOCIO P
Address: 379 ROYAL PALMS DR
GENERAL CONTRACTOR INFORMATION:
Name: TERRY VEREEN PLUMBING
,CFCO25597
Address: 2934 POST ST CIA TERRY LEE VEREEN
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $84.00
Trade Permit Base Fee $55.00
Total Payments: $143.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CnV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH v
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 I (�' -PL6G -Z8g7
JOB ADDRESS:
<� ( PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
" TYPE OFFfXTURE QTY TYPEOFFixTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain
Floor Sink Three Compartment Sink
Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water IT
—'
Other Fixtures _ star Treating System
RE-PIPE: `�
TYPE orF7XTURE QTY TYPE OFFLXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer t Shower
Dishwasher Shower Pan _
Drinking Fountain Slop Sink _
Floor Drain
Floor Sink Three Compartment Sink
Toilet
Hose Bibs _ Urinal
Kitchen Sink �_ Vacuum Breakers _
Laundry Tray Water Connected Appliances
Lavatory '3. Water Heater I
Other Fixtures Water Treating System T—
MSCELLANEOUS:
7 Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap)_gallons(Requires 3 sets of plans)
7 Lawn Sprinkler System-Number of Heads ❑ Well *+
'*SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
i Other
crmit becomes void if work does not commence within a six month period or work is suspended or abandoned for sm months.I he certify That 1 have read
its application and know the mme to be true and canece All provisions of laws and ordinances governing this work will be complied with whether specified
not. The permit does not give authority In violate the provisions;of my other slate or local law regulation construction or the performance of construction.
mperty Owners Name ... Phone Number
lumbingCompany_ Zi(V yet.i,.v+zn jy't�A �,.; .ry Office Phone .'%8'd-S�6=i Fax ">84-SLIX,
o.Address.-�_ ;AC `jyl . .
City �G c N - i,� i l� State�L Zip ,��S i `(
icense Holder(Print): 'Tule V Ir I—,-'EhI i State Certification/Registration# CFC u 2 SSQ�
"otariZed Signature of License Holder ii lam-^---•—
nr TIFFANY N WILSON Sworn and subscribed blefore me this ?gJth day of f'VLI V 20L
COMMI881S 10 FF2018 Signature of No Public �l�
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