2393 Ocean Breeze Ct plbg permit (2) -f'
i Y
CITY OF ATLANTIC BEACH
y 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-3525
Job Type: PLUMBING ONLY
Description: PLUMBING - 2 FIXTURES
Estimated Value:
Issue Date: 3/17/2017
Expiration Date: 9/13/2017
PROPERTY ADDRESS:
Address: 2393 OCEAN BREEZE CT
RE Number: 168908-8230
PROPERTY OWNER:
Name: HANSEN, KIRK& BONNIE,
Address: 2393 OCEAN BREEZE CT
GENERAL CONTRACTOR INFORMATION:
Name: COOKS EAST COAST PLUMBING
,CFC044206
Address: 4850 OUTRIGGER DR QA EDGAR COOK, JR
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $14.00
Trade Permit Base Fee $55.00
Total Payments: $73.00
PERMIT IS APPROVED ONLV IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BDILDENG CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 .1 -7 P L -j S7j
JOB ADDRESS: c� OG E,Kl I Q JZ.- tom'r .r I PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFIXTORE QTY TYPE oFFIXTURE 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 �J Water Treating System
RE-PIPE:
TYPE oFFixTURE QTY TYPE oFFIXTURE 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 1 have read
this application and know the same 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 my other state or local law regulation construction or the performance of construction.
Property Owners Name 1 /fr IS U JV e.n lz OA-) Phone Number
Plumbing Company
co() [—A$ `t CDA s PLOffice Phone 90 Y to 42.t 13H Fax
Co. Address: S C)S (7�:r city State FL- Zip 3;1.aa �
License Holder(Print): re n o r- G42 ok -J f% State Certifi on/Registration# G F C O E/r-t a a&
Notarized Si nature o License Holder
TONIGINDIESPEROpi^Ea fore me this da f r 0
" r. MY 00MMISSION OHNSAXI
+aam ature of Notary Public