407 Irex Rd plbg permit CITY OF ATLANTIC BEACH
l 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-3248
Job Type: PLUMBING ONLY
Description: SEWER - LATERAL REPAIR
Estimated Value:
Issue Date: 2/13/2017
Expiration Date: 8/12/2017
PROPERTY ADDRESS:
Address: 407 IREX RD
RE Number: 171416-0000
PROPERTY OWNER:
Name: LONG, DAVID A& CONNIE ROBBINS,
Address: 407 IREX RD
GENERAL CONTRACTOR INFORMATION:
Name: EASTERDAY PLUMBING INC
,CFC1426179
Address: 6653 PWOERS AVE APT 241 QA GREGORY ALAN
EASTERDAY
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $7.00
Trade Permit Base Fee $55.00
Total Payments: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 ,1
Ph(9044)247-5826 Fax(904)247-5845 17 —PLZ[�,3 Z48)
JOB ADDRESS: y 7 1)QX PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFIXT(IRE QTY TYPE OFF/XTORE 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 of FIXTURE QTY 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 ❑ 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 some 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 any other state or local law regulation construction or the performance of construction.
Property Owners Name ,Ay E Lori(r Phone Number 90y- 7119 - 6
Plumbing Company FASIERl)fA16)(TOffice Phone9D4 SZZax
-
Co. Address: ` 3 N v I UoJ ZQ� City State 7r/Zip 3AS7
License Holder(Print): C State Certification/Registration# &%J
Notarized Signature o License Holder
TONI GaILESPERGER Befofmeis da 20
MYCOMMISSON#FF92a951yEXPIRES:oewta 6.2019
SignNotary Public