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411 Whiting Ln 17-PLBG-3252 plbg permit CITY OF ATLANTIC BEACH j 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-3252 lob Type: PLUMBING ONLY Description: sewer replacement Estimated Value: $1,500.00 Issue Date: 2/14/2017 Expiration Date: 8/13/2017 PROPERTY ADDRESS: Address: 411 WHITING LN RE Number: 171442-0000 PROPERTY OWNER: Name: JONES, ROSIE L Address: 411 WHITING LN GENERAL CONTRACTOR INFORMATION: Name: TERRY VEREEN PLUMBING ,CFCO25597 Address: 2934 POST ST QA TERRY LEE VEREEN Phone: - FEES: Plumbing Fixtures $7.00 State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 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 (� 'Ph(904)247-5826 Fax(904)247-5845 JOB ADDRESS:_ / I ' o PERMIT# 3asa PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value 8 oIZ) TYPE OFFamRE QTY TYPEOFFIXTURE Q Bathtub TY Clothes Washer Septic Tank&Pit Dishwasher Shower Drinking Fountain Shower Pan Floor Drain -- Slop Floor Sink Three SiCnok mpartment Sink -- Hose Bibs Toilet Kitchen Sink -- Urinal Laundry Tray Vacuum Breakers yavato --- Water Connected Appliances Other Futures Water Heater Water Treating System RE-PIPE: TYPE OFFDTURE QTY TYPE OFFIXTORE QTY Bathtub Septic Tank&Pit Clothes Washer -- Shower — Dishwasher Shower Pan — Fluorng Fountain FSlop Sink Floor Drain Compartment Sink Floor Sink P KitcHoshen Urinal — Bibs Toilet Three Com — Kitchen Sink Vacuum Breakers — Laundry Tray Water Connected Appliances — Other Fixtures Water Heater Water Treating System — 1SCELLANEOUS: Sewer Replacement ❑Back Flow Preventer ❑ Grease Interceptor(Trap)_ gallons(Requires 3 sets of plans) O Lawn Sprinkler System-Number of Heads 0 Well +* **SIRWD Well Completion Form. Completed form to be submitted to the—BOTd—ing Department for final inspection.* ❑ Other Permit becomes void if work dna not commence within a six month period or work is suspended or abandoned for six months.l h this application and knew ate seine m be true and correct All provisions of laws and ordinances goveming this work will h complied with whethercertify that specifiedor not. The permit does not give a�ad/n ityto violate the provisions ofany otherstate or local law regulation mnwells ill be ofthersudion. Property Owners Na mTe_1`�a $I .e- ��n O 3 Phone Number oP-y6 - 7a 16 Plumbing Company. 1 -Q.( ` \r Ve C.!,i n IPE!C:42 OfficePhom 36q S 51 Fax 3 UjZV U Co.Address: b 11 S _ City J- A.Y V,-Stote 1aL zip 32!aa/ License Holder(Print): -C State Certification/Registration# Notarized Signature of License Ho/�e TIFFANY 4x—iSw mend subscribed before me this_�3t" day ofuar�-I 20� xmxavwauc .raaor WILSON.. COMMISSIONS FFISS569 /1 � EXPIRES 10114/2018 Signature of Notary Public 'A Q,t�tA 1 naornnwu+awaorr l