796 Main St plbg permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j � 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: 17-PLBG-3105
Job Type: PLUMBING ONLY
Description: PLUMBING - ONE WATER HEATER
Estimated Value: $750.00
Issue Date: 1/26/2017
Expiration Date: 7/25/2017
PROPERTY ADDRESS:
Address: 796 MAIN ST
RE Number: 170942-0050
PROPERTY OWNER:
Name: SAPIA, PETER C
Address: 1655 SELVA MARINA DR
GENERAL CONTRACTOR INFORMATION:
Name: BROWARD FACTORY SERVICE BFS
Jerry Leroy Brightwell,CAC056774
Address: 2071 EMERSON ST CIA JERRY LEROY BRIGHTWELL
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: $66.00
PERMIT IS APPROVED ONLY W ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDmA14CES AND THE FLORmA
BDILDMG CODES
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH f�L I
800 Seminole Rd Atlantic Beach,FL 32233 17 — p� 3c —310S
Ph(904)247-5826 In(904)247-5845
�9 (o Ma;n S+(P¢ 3P'' j
JOB ADDRESS: � /-�';lan 4'r I�eac In PERMITN
NEW OR REPLACEMENT INSTALLATION: Project Value$ 7500
TYPE or FIXTURE QTY TYPE oFFIXTURE QTY
Bathtub Septic Tank&Pit _
Clothes Washer Shower _
Dishwasher Shower Pan
Drinking Fountain Slop Sink _
Floor Drain Three Compendium Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers _
Laundry Tray Water Connected Appliances
Lavatory Water Heater Z
OtherFwmres Water Treating System
RE-PIPE:
TYPEoFFixmitE QIT TYPEoFFIXTORE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Rain Three Compartment Sink _
Floor Sink Toilet
Hose Bibs unnal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Futures Water Treating System
MISCELLANEOUS:
Sewer Replacement cBack Flow PmVcmcr Grease Interceptor(Trap) gallons(Remints 3 sets of pians)
Lawn Sprinkler System-Number of Heads -. Well
**SJRWD Well Completion Form.Completed form to be submitted tot x�ng*Department for rani inspection.**
Other
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nils application aM knox'tM1e cane W M trot aM tomer All pmvisionsofbws and oNmanreagoveming this week will beroandied wnM1 wMrhms awrfiM
orros. The permit does nix give ashoutsr,iotatieflar,rovisionsedfany ether wer or load law mgulmian cannsumion orlhepeRarmvrra ofmnaoucnm.
Property Owners No.,! Phone Number 4'04-3011-(,01L
Plumbing Company lNewanl FAc�ypf Set Jcz Office PhoneYc•135 I, I, Fax9Lei-44 ii,
Co.Address: � M City :3 - spno.(l, State�r_ Zip 3,Lc7
License Holder(Print): ( '
I c stm[ioa R C FCL SL Rt.7
Notarized Signature of License Halder
SwomNIC
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