1655 ATLANTIC BEACH DR - PLUMBING sr'
f �s f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J _____)1 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-3409
Job Type: PLUMBING ONLY
Description: install 22 fixtures
Estimated Value:
Issue Date: 3/3/2017
Expiration Date: 8/30/2017
PROPERTY ADDRESS:
Address: 1655 ATLANTIC BEACH DR
RE Number: None
PROPERTY OWNER:
Name: TOLL FL VI LIMITED PARTNERSHIP
Address:
GENERAL CONTRACTOR INFORMATION:
Name: DARLEYS PLUMBING INC.
, CFC056702
Address: 4472 PHILLIPS HWY QA CARL LESLIE DARLEY
Phone: - -
FEES: ------- —Plumbing Fixtures $154.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $213.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING
PERMIT APPLICATION (5
e CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
1L5 Phh(904) 247-5826 Fax (904) 247-5845 _ Pi_eL. _ Z •t.o'
JOB ADDRESS: /'1- 'L` )?c i Q". PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub —3___ Septic Tank& Pit
Clothes Washer _l Shower
Dishwasher __J Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet -`'—
Hose Bibs Z Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray I Water Connected Appliances )
Lavatory .S Water Heater _t_
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE 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:
El Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
El Lawn Sprinkler System-Number of Heads E Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
Li 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 ..-&-____F•. n.o s Phone Number
Plumbing Company QiQ24F.,.,!I ?.. '.L Office Phone 7n /YS Y Fax ?z? / '8r
Co. Address: tit(7 L P K.7iS /44,41 Y City INV State Ft Zip ?Lt o?
License Holder(Print): Com.&. G. °A /State Certification/Registration# C/t ()SSW Z.
Eaaanirad Si �i License older a n N..—(�f
1 ,,‘aY''4 JOANNE MEHL ( `� NO
9 `B 1.-s Notary Public-State of Florida Sworn and subscribed before this Z. day of i M 20
• Commission•GG 021781 I �-
1 -;„,,f OF MyComm.Expires Aug 29.2020 : Signature of Notary Public t 04+r
��''',..,..""`° Bonded though National Notary Assn. P