1667 Atlantic Beach Dr plbg permit CITY OF ATLANTIC BEACH
;. 800 SEMINOLE ROAD
U 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-3160
Job Type: PLUMBING ONLY
Description: install 23 fixtures
Estimated Value:
Issue Date: 2/2/2017
Expiration Date: 8/1/2017
PROPERTY ADDRESS:
Address: 1667 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 $161.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $220.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
PLUMBING PERMIT APPLICATION 23
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JoB ADDRESS: IL67 f} L44 Txc .t'ihr-M A PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFF/XTURE QTY TYPE or,FIXTURE QTY
Bathtub 2- Septic Tank&Pit
Clothes Washer I Shower
Dishwasher I Shower Pan _L
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet ?
Hose Bibs i Urinal
Kitchen Sink -J— Vacuum Breakers
Laundry Tray / Water Connected Appliances T
Lavatory T Water Heater I
Other Fixtures Water Treating System I
RE-PIPE:
TYPE of FIXTURE QTY TYPE oFFIXTORE 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 ❑ Well **
**S/RWD 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 tine 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 my other state or local law regulation construction or the performance of construction.
Property Owners Name I ei,� &.. Phone Number
Plumbing Company bA&9=1: ria --02-s L..c. Office Phone 70 -/Yxy Fax 72? /yBl
Co. Address: VY 7t- hrzcy s rf. !r City —J–AA State k- Zip 31-1-7
License Holder(Print): M.a- L Q/4, ✓• State Certification/Registration# C& o C6 7 x
!folder V-f
,p .v JOANNE HL
` 6 Notary Public-stat at Florida Sworn and subscribed before a this Z"n day of FT7f o.N 20�
Commission#GG 021781
My Comm.Expires Aug 29.2020 Signature of Notary Public
BundadtAmuoA Nalunue Notary Assn.