712 Vecuna Rd plbg permit �SI
CITY OF ATLANTIC BEACH
r 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-3115
Job Type: PLUMBING ONLY
Description: PLUMBING - 3 FIXTURES
Estimated Value:
Issue Date: 1/26/2017
Expiration Date: 7/25/2017
PROPERTY ADDRESS:
Address: 712 VECUNA RD
RE Number: 171361-0000
PROPERTY OWNER:
Name: MCGLYNN, DORIS M
Address: 712 VECUNA RD
GENERAL CONTRACTOR INFORMATION:
Name: ELITE PLUMBING
,CFC1429433
Address: 944 Steeple Chase Ln Orange PARK STEEPLE
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $21.00
Trade Permit Base Fee $55.00
Total Payments: $80.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845 l? - P QQ,�; ( LS
JOB ADDRESS: 71Z 4cuat4 PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ /. foo %m
TYPE ol,F=AE QTY TYPEOFFWuAE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower -Tv
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet J_,C
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory J X Water Heater
Other Fixtures Water Treating System
RE-PTFE: /fes
TYPE oFFIXTuRE QTY TYPE OFFDtmAE 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 ❑ Back Flow Preventer 17 Grease Interceptor(Tmp) 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 n onths.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 Srd uN w 15te, ,at6 Gtoup cot&Kudw Phone Number 9orl-7Z9-1541,
Plumbing Company !1* Plu"b JG CtG Office Phone 314-66t-SV73 Fax
Co.Address: 444 34t2P1ec1.,,6E tal City OIw�Petk State Fl. Zip 3z,[,5
License Holder(Print): '!)AQ,mL e HATtife . 71- 1 >49tateCertificationfRegistation# q%gg33CLre )
Notarized Signature of License H [der
GE
TONI G�pMpAI5i FMaLESF F
` t efore me this day o 20 1 -7
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1 E%PIRES:nctcper 8,.2at9
��ar°� e,dcev�emummTa° ignatureofNotary Public