178 Seminole Rd plbg permit j LA'yi'!�S
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
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PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-PLBG-3048
lob Type: PLUMBING ONLY
Description: PLUMBING - 11 FIXTURES
Estimated Value: $5,000.00
Issue Date: 1/19/2017
Expiration Date: 7/18/2017
PROPERTY ADDRESS:
Address: 178 SEMINOLE RD
RE Number: 170594-0000
PROPERTY OWNER:
Name: MARTIN, JOHN E
Address: 178 SEMINOLE RD ATLANTIC BEACH FL.
GENERAL CONTRACTOR INFORMATION:
Name: OGRE PLUMBING CONTRACTORS INC
,CFC1428315
Address: 5340 Otter LN
Phone: 904-312-8102
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $77.00
Trade Permit Base Fee $55.00
Total Payments: $136.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDWANCFS AND THE FLORIDA
BUILDING CODES
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PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 �7_FL�3 G _3048
JOBADDRESS: ng S(MrNele kJ PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ S 070
TYPEOFFErmAE QTY TIPEOFFDaURE QTY
Bathtub Septic Tank&Pit „ r.
Clothes Washer Shower I o e J uJ re
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 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:
❑ Sewer Replacement 0 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
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for sixmonths.I hereby certify that I have read
this application and know the same to he 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 Mher state or local law regulation construction or the performance of constriction.
Property Owners Name r-lan K ✓✓ CL' Phone Number
Plumbing Company "3M f(yw Is tryG ��&a c MY-5 Office Phone ?0`111.74102 Fax
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Co.Address:_5346 0(itet' tg8e City Mtddl6 yr State Pt Zip3 6
License Holder(Print): KempkefSc[7roer-
-State Certiffcation/Registration# (fic(Y205
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