469 Atlantic Blvd #13 plbg permit �tyL%j
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
306 INFORMATION:
Job ID: 17-PLBG-3036
Job Type: PLUMBING ONLY
only) Description: re-pipe sink, laundry tray, 2 hand sinks (re-pipe hot water
Estimated Value: $1,100.00
Issue Date: 1/18/2017
Expiration Date: 7/17/2017
PROPERTY ADDRESS:
Address: 469 ATLANTIC BLVD UNIT 13
RE Number: None
PROPERTY OWNER:
Name: DIAMOND REAL ESTATE PROPERTIES
Address: 6517 LOU DRIVE S
GENERAL CONTRACTOR INFORMATION:
Name: A TO Z CONTRACTING AND PLUMB
Brett Alan Thomas,CK1427822
Address: 406 HAMLET RD BRETT ALAN THOMAS
Phone: -
FEES:
Plumbing Fixtures $35.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
I
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
t� - P�-c3G-3U3�
JOBADDRESS: Y&Cn J14 -iLj0r41C, AIUn �-In�t /3 PERMIT#
NEW OR REPLACEMENT INSTALLATION: ProjectValue$'0
TYPEOFFfxTORE QTY TYPE OFFtxTuRE QTY
Bathtub Septic Tank.&Ph
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
RE-PIPE:
TYPEoFFtxTURE QTY TYPEOFFIXTT/RE 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 ConnectedAppliances
He
Lavatory Water Heater
Other Fixtures 1E Water Treating System
MISCELLANEOUS: 14AA,'t 61-VL'S
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sera of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well ••
**SIRWD Well Completion Form. Completed form to be Submitted to the Building Department for final inspection.**
ii Other P,,(fAP-e0 t-167 ( k-:)cL -e-r Ur) I`i
,
Permit biomes void if work does not commence within a six nsonN period or work is suspended or abandoned for six monNs.1 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 out. The permit does our give authority N violate the provisions of my other state oor local law regulation construction or the performance ofcommo tion.
Property Owners Name D i&a J �B� Rop2t-T1`2 S Phone Number'&+ (,e.
PltmtbingCompany OfficePhone3"700"I ) FacciOL) (-7.1p
Co.Address: L-(OU. l` CL0Y\L2_f- City . Gk-le State(Zip3 Z.LZ/
License Holder(Print): ! ` V� ( V\CJS-k State Certification/Registration#CRC 142 7 V22-
Notarized
2ZNotarized Signature ojLicense Holder _
Swom and subscribed before me this 1 I day of ��..� 20 I l
SEAN NARKENREADER �-�—
NotaryPuellc-Slate of florlda Signature of Notary Public
My Comm.Expires Mar 9,2010
in�.fio' Commlasion N fF 000097