467 Selva Lakes Cir plbg permit 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
]OB INFORMATION:
Job ID: 17-PLBG-3180
Job Type: PLUMBING ONLY
Description: re-pipe 17 fixtures
Estimated Value: $5,719.89
Issue Dace: 2/6/2017
Expiration Date: 8/5/2017
PROPERTY ADDRESS:
Address: 467 SELVA LAKES CIR
RE Number: 172027-5022
PROPERTY OWNER:
Name: GARCIA, GEORGE
Address: 467 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: EARY PLUMBING
Benjamin Paul Eery,CFC 1428812
Address: 1870 Swiss Oaks St ST
Phone: 904-460-3438
FEES:
Plumbing Fixtures $119.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $178.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDPVANCFS AND THE FLORIDA
BUILDING CODES
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 ?n3�
JoB ADDRESS: �f, 7 fc fuo G a k r r A H,tik (' PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ TJ71, d2
TYPE OFFi=AE QTY TYPE OFFEUVRE 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:
TYPE OFFIXTORE QTY TYPEOFFDXWRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher �_ Shower Pan Drinking Fountain Slop Sink
Floor Thain Three Compartment Sink
Floor Sink Toilet
Hose Bibs 2 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 **
**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 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 constmction or the performance of construction.
Property Owners Name7 F(f/'Q C �9/tiy-z-I� Phone Number
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Plumbing Company �0a�o OfficePhone
Co.Address: W21 LiSSeAK 1d-reed' city AT644.5 State, zip72;?J51
License Holder (Print): Ly ,`n 0.d State Certification/Registration# 9(KZ 02
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Signature of Notary Public \a.