145 8TH ST - PLUMBING ' ' ' ° S f 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
JOB INFORMATION:
Job ID: 17-PLBG-3356
Job Type: PLUMBING ONLY
Description: PLUMBING - RE PLUMBING 18 FIXTURES
Estimated Value: $10,500.00
Issue Date: 2/27/2017
Expiration Date: 8/26/2017
PROPERTY ADDRESS:
Address: 145 8TH ST
RE Number: 170323-0000
PROPERTY OWNER:
Name: Sellers, Jeffrey B
Address: 145 8Th ST
GENERAL CONTRACTOR INFORMATION:
Name: J D PHILLIPS PLUMBING, INC.
James Dolphe Phillips, CFC041782
Address: 850504 US HWY QA JAMES DOLPHE PHILLIPS
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $126.00
Trade Permit Base Fee $55.00
Total Payments: $185.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 17- PLBG -335G
JOB ADDRESS: I i 5 ? /47 5+• ! T !Z C Lc-c-11 PERMIT# /2c.— RAW.;.17.
NEW OR REPLACEMENT INSTALLATION: Project Value$ JO 5b01-
TYPE
be1-TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 2 Septic Tank&Pit
Clothes Washer —77— Shower 2.-
Dishwasher
Dishwasher — I Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs Z Urinal
Kitchen Sink _7___— Vacuum Breakers
Laundry Tray —7- Water Connected Appliances
Lavatory li Water Heater _L
Other Fixtures Water Treating System
RE-PIPE: 1
TYPE OF FIXTURE Q' Y �r r 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 ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads 0 Well **
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**n
'Other t.- d,.-ts-.-A-9 4 c QQ —71 j J
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 32 ( .e Phone Number
Plumbing Company J • .C1,-• 1 ,('c PLu-u-� "'t C`'1:7"- Office Phone 90 `t Zzs` 577Fax
Co. Address:8 cD Sai/ Ct S ley/7 Yi.k.1cse- City u1C2r State C/ Zip 3 ZD9 7
License Holder(Print): 0 eL. t 1,a. State Certification/Registration#e_A /CD c /7 d72—
Notarized Signature of License Holder i
J•
.4.;:"=Z,,, TONI GINDLESPERGER Befor me this �7 day f �j-� 20.
't. ;s MY COMMISSION#FF 924951
%:; ,a EXPIRES:October 6,2019 Signature of Notary Public
R p��t°;' g�nded Th u Notary Publ c Urderwrters f