405 Royal Palms Dr plbg permit S ly�,lri
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
_ ATLANTIC BEACH,FL 32233
� X INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5614
]OB INFORMATION:
lob ID:
lob type: PLUMBING ONLY
Description: install 6 fixtures
Estimated Value:
Issue Date: 3/6/2017
Expiration Date: 9/2/2017
PROPERTY ADDRESS:
Address: 405 ROYAL PALMS DR
RE Number: 171488-0000
PROPERTY OWNER:
Name: Ramsey, Kenyatta
Address: 405 Ro al Palm DR
GENERAL coNTRACTOR INFORMATION:SHAWN ORR PLUMBING CO INC
Name:
Shawn G.Off,CFC056893
Address: 4645 DEKLAB AVE SHAWN ORR
Phone: -
FEES:
Plumbing Fixtures $42.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $101.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
U
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
p
Ph(904)247-5826 Fax(904)247-5845
.IOB ADDRESS: /L V ) fir~�r<. s PERMIT# �7' RAD-313 6
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFixTURE QTY TYPE oFFIXTuRE 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
RE-PIPE:
TYPEoFFtxTuRE QTY TYPEOFFIXTuRE QTY
BathtubSeptic Tank&Pit —
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink —
Floor DrainThree 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:
o Sewer Replacement ❑ 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 six months.I hereby certify that I have read
this application and know the same to be one 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 e of any other state or local law regulation construction or the performance of construction.
Property Owners Name `e n l a 1 Tk Jzck \ 5 Phone Number
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Plumbing Company TC! g Orr'S U �°`^�"��' C� Office Phone 3Y3- 3 G3 ( Fax
Co. Address:�-n _.,rt
rrr� NF-kr �b Al ,eCity State R- Zip32Zo7
License Holder(Print): 5kAW �s• Stpt,e Certification/Registration#CFL eS 6 84 3
MIX"
Si nature Bence Holder i U•f.`f/t--�
JENNIFERJONNSTON Beforeme this (0 � day of 1"`�� 20ptt OOMMI3SI0N4GG 0/188!E%PIRES:Ocb08rn.181014xdaaTvu NOWYPuabWtl«M1Yn Signature of Notary Public