25 10th St plbg permit 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
]OB INFORMATION:
Job ID: 17-PLBG-2918
Job Type: PLUMBING ONLY
Description: PLUMBING -WATER HEATER
Estimated Value:
Issue Date: 1/4/2017
Expiration Date: 7/3/2017
PROPERTY ADDRESS:
Address: 25 10TH ST
RE Number: 170263-0080
PROPERTY OWNER:
Name: AMARRC LLC
Address: 3604 RIVER HALL DR
GENERAL CONTRACTOR INFORMATION:
Name: WATSON PLUMBING
Miles Edward Carlyon,CFC057664
Address: 4456 SUNBEAM RD APT 200 MILES CARLYON
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $7.00
Trade Permit Base Fee $55.00
Total Payments: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
L Ph((99(04)247-5826 Fax (904)247-5845 _ PL&:,_ 53
JOB ADDRESS: 015 I 44\ JT• PERMIT# V
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPEOFFixTuRE 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 T
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE QTY TYPEOFFIXTORE 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:
o Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
**SJRWD Well Completion Farm. 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
this application and know the same to be true and correct. All provisions of laws pnd ordinances governing this work will be complied with whether specified
or not The permit does not give authority to violate the provisions of my other state or local law regulation construction or the performance ofnorimuction.
Property Owners Name AmWRZ LLC, Phone Number 5.34 -2179'
Plumbing Company WAk5c'm Nrn)Qwc Office Phone 737Jo337 Fax R99—da&
Co. Address: 44%-3.w SoaA"m 0- City 3k_kf'0aVt 'd5 7
License Holder(Print): E ( Certification/Registration# •F -I) 7664
Notarized Signature of License Holder
I
star. ' Sworn and subscribed before in, 20 7
KELLYMWM
MY COMMISSION IFF087109 y _EXPIRESMarch 2,2018 Signature of Notary Public
.
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