112 Fleet Landing Blvd plbg permitCITY 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-2935
Job Type:
PLUMBING ONLY
Description:
relocate kitchen sink & drain
Estimated Value:
Issue Date:
1/5/2017
Expiration Date:
7/4/2017
PROPERTY ADDRESS:
Address:
112 FLEET LANDING BLVD
RE Number:
LOC ID -0000
PROPERTY OWNER:
Name:
NAVAL CONTINUING CARE
Address:
1 FLEET LANDING BLVD 1 FLEET LANDING BLVD
GENERAL CONTRACTOR INFORMATION:
Name:
DAVID GRAY PLUMBING INC.
David Fred Gray, CFCO22586
Address:
6491 S POWERS AVE QA DAVID FRED GRAY
rnm,e -
FEES:
Plumbing Fixtures $7.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $66.00
PERMIT IS APPROVED ONLY M ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLOMA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS:
NEW OR REPLACEMENT INSTALLATION:
RE -PIPE:
TYPEOFFIxTURE
Bathtub
Clothes Washer
Dishwasher
Drinking Fountain
Floor Drain
Floor Sink
Hose Bibs
Kitchen Sink
Laundry Tray
Lavatory
Other Fixtures
TYPEOFFIxTURE
Bathtub
Clothes Washer
Dishwasher
Drinking Fountain
Floor Drain
Floor Sink
Hose Bibs
Kitchen Sink
Laundry Tray
Lavatory
Other Fixtures
QTY
I I - puacl- aa3s
PERMIT # _
Project Value $
TYPEOFF7xTURE QTY
Septic Tank & Pit
Shower
Shower Pan
Slop Sink
Three Compartment Sink
Toilet
Urinal
Vacuum Breakers
Water Connected Appliances
Water Heater
Water Treating System
QTY TYPE OF FIXTURE QTY
Septic Tank & Pit
Shower
Shower Pan
Slop Sink
Three Compartment Sink
Toilet
Urinal
Vacuum Breakers
Water Connected Appliances
Water Heater
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 re/0Cr0!2 4./z'hzfn 57inL dr in
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for sin months. I hereby certify that l nave man
this 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 violate the provisions of any other state or local law regulation construction or the performance of con's/min&- ion.
f ✓C &" Phone Number OV � I/moi[
Property Owners Name _
Plumbing Company UI Office Phone 16- i Fax 9 7y.Sl1<
Co. Address: l!/ City, , State 6,p Zip &,Xe�J�
License Holder (Print): State Certification/Registration # l FC (p
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