146 Ocean Gate Dr plbg permit f:yLJri
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
JOB INFORMATION:
Job ID: 17-PLBG-3628
.Job Type: PLUMBING ONLY
Description: install 11 fixtures
Estimated Value:
Issue Date: 3/30/2017
Expiration Date: 9/26/2017
PROPERTY ADDRESS:
Address: 146 OCEAN GATE DR
RE Number: None
PROPERTY OWNER:
Name: HABITAT FOR HUMANITY OF JB INC
Address: 1671 FRANCIS AVEL
GENERAL CONTRACTOR INFORMATION:
Name: ADVANTAGE PLUMBING
Gregory K.Gause,CFC1425959
Address: 880 MAYPORT RD QA GREG GAUSE
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 Payments: $136.00
PERMIT IS APPROVED ONLY IN ACCORDANCE Wn'H ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
N800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
Jos ADDRESS: 0-4tedA, 11
PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPEOFFIXTuRE QTY TYPEOFftaURE QTY
Bathtub I Clothes Septic Tank&Pit
Washer
Dishwasher —� Shower Pan —L
Drinking Fountain Slop Sink —'
Floor Drat°
Floor Sink Three Compartment Sink
Toilet
Hose Bibs Urinal
—
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Other
Lavatory
Water Heater T-
Water Treating System
RE-PIPE:
TYPEOFFMvRE QTY TYPEOFFOrTORE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower —
Drinking
Shower Pan —
king F Fountain Slop Sink
Floor Drain Three itparhnem Sink
Floor Sink Toilet —
KitcHoshen
Bibs itchen Sink UrinalVacuum Breakers
Laundry Tray Water Connected Appliances
Other FiLavatoxtures Water Heater PP
Water Treating System _
MISCELLANEOUS:
❑ Sewer Replacement ❑Back Flow Preventer ❑ Grease Interceptor(Trap)_gallons(Require 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
Pennit beconift void if work does not comonence within.six month penal or work is suspended or abandoned for sox months.T hereby certify that 1 have read
this application and know the same to be true and correct. All pmvisions oflaws and ordinances governing this work will be complied with whether specified
or not The permit does not give authority tonviQlste the provisions of my other state or local law,regulation constmction or the performance of construction.
Property Owners Name H�/, 141'r Phone Number
Plumbing Companyt� I�IA),8/�lCj OfficePhoneJY7. 99YrF Faxe2y >- T-CW/
Co.Address: City ML 1"�J State,6 zip3Z2.33
License Holder(Print): �f b tate Certification/Registration#P�yg {Tj
Notarized Signature ojLicense Holder
err,?P(;tit %NIFENJ°HNSTM Before me this
urcouulssloNaccana flay of Wr-h 20
E IHEs'.adoGrlr,ane _
Signature of Notary Public
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