405 Royal Palms Dr plbg permit (2) CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Jab ID: 17-PLBG-3197
Job Type: PLUMBING ONLY
Description: install 11 fixtures
Estimated Value: $2,490.00
Issue Date: 2/7/2017
Expiration Date: 8/6/2017
PROPERTY ADDRESS:
Address: 405 ROYAL PALMS DR
RE Number: 171488-0000
PROPERTY OWNER:
Name: Ramsey, Kenyatta
Address: 405 Royal Palm DR
GENERAL CONTRACTOR INFORMATION:
Name: SHAWN ORR PLUMBING CO INC
Shawn G.Orr,CFC056893
Address: 4645 DEKLAB AVE SHAWN ORR
Phone: -
FEES:
Plumbing Fixtures $77.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payment.: $136.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 �-
JoB ADDRESS: qo.5 Q ay�P l rt s D/L PERMIT# 1-7t
NEW OR REPLACEMENT INSTALLATION: Project Value$ Ct 0 1J'
TYPE oFF7XTORE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher J Shower Pan _
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 7
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures W Water Treating System
RE-PIPE:
TYPE of FIXTURE QTY TYPEOFFIXTURE 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 **
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other &OL&� in_ �m?'.� 'j:lt lu under *0 r,J A4-;o Lal e 7-lIcr CT-Ir—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 stale or local law regulation construction or the performance of construction.
Property Owners Name eeA_�G - mSey Phone Number
2
Plumbing Company�V lri✓lo Ce, Office Phone lloy-3Y3';36.3/ Fax
Co. Address: LAK S D e K�,Ib /ape- cityl AJC State Zip 3Z Z�7
License Holder(Print): 5tMJjAj (r O cr State Certification/Registration#c r c 056 893
Notarized Si nature of License Holder e02
JQlPIIFERJOHNarON y to(l1Rt T
•R "> Before me this �1� da of f�Q. 20 l
nv G(IMaISSIGN p GG 0/2961
UPIRES:0,vser 2).2020
t�,y,,;; �` 9mdetlnw NONry Pwrc una.r nwa Signature of Notary Public UUe-vl vt-�W1 t �