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1249 BEACH AVE - PLUMBING >' 1 .V \S, CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD j; ......ll 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-2874 Job Type: PLUMBING ONLY Description: PLUMBING GARAGE- 18 FIXTURES Estimated Value: Issue Date: 12/27/2016 Expiration Date_: _ 6/25/2017 PROPERTY ADDRESS: Address: 1249 BEACH AVE RE Number: 170292-0000 PROPERTY OWNER: Name: Boeneke, Demory Address: 7093 Ox Bow RD GENERAL CONTRACTOR INFORMATION: Name: TDG PLUMBING , CFC1427062 Address: 4426 LOYS DR QA TRAVIS DALE GAINEY Phone: 904-545-7341 FEES: State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Plumbing Fixtures $126.00 Trade Permit Base Fee $55.00 Total Payments: $185.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. • PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 247-5826 Fax (904) 247-58451 Cj_ PU3 _ Z E574 JOB ADDRESS: laLict'" 4/ I�ci\CI-f. PERMIT# C PAGE NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub __ Septic Tank&Pit Clothes Washer _A_ Shower _Z__ Dishwasher -t--- Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet w Hose Bibs ___ Urinal Kitchen Sink liVacuum Breakers Laundry Tray Water Connected Appliances Lavatory - Water Heater 1 Other Fixtures \ Water Treating System RE-PIPE: TYPE OF FIXTURE QTS' TYPE OF FIXTURE 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 0 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 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 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 construction. Property Owners Name e mo i oen P K Q Phone Number Plumbing Company-7-'1C) a CP 1...i.,.\p;4v%�� n C Office Phone S S Th 4 Fax.vt..`i"t ts1 Co. Address: Li k2 kr. Loi S Z City . Act State FI Zip 322M S` License Holder(Print): l (Z.A., Z 3 0 e,Al./142 State Certification/Registration# e fC^t 7c c. Notarized Si nature of License H.oldet �) , I ;yµ'.ei ,; TONIGINDLESPERGER Before me this 7da �' t...14 0 ` (� y; La, ;., MY COMMISSION#FF 924951 / s•;�5g- EXPIRES:October 6,2019 '-OM '��gn°`�' Bonded ThruNoaryPublic Underwrt?ra Signature of Notary Public _, N