150 Ocean Gate Dr plbg permit ?, 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-3625
Job Type: PLUMBING ONLY
Description: install 11 fixtures
Estimated Value:
Issue Date: 3/30/2017
Expiration Date: 9/26/2017
PROPERTY ADDRESS:
Address: 150 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. Gauss,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: $136.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: /_�ord K�q 4 PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TFPEOFFmwRE QTF TYPEUFFWURE QTY
Bathtub Septic Tank&Pit
Clothes Washer I Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet w2—
Hose Bibs _� Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPEOFFixTURE QTY TFPEOFFIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain
Floor Sink Three Compartment 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(Requires2l sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
**SlRWD 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 true and correct. All pmvisions of laws and ordinances governing this work will be complied with whether specified
or noL The permit does not give authority to violate the provisions of any other store or local law regulation construction or the performance of construction.
Property Owners Name Phone Number
Plumbing Company - ) Office Phoneo2Y7- 9&yr9 Faxa25r 9- 9r4F�
Cca. Address: 'r5D mQ.JF' �f City ��L 6U, State.�zip.37a33
License Holder(Print): � C V State Certification/Registration#Pf! 150_!W
Notarized Signature of License Holder
LOA—
rERJOHNSTON Before me this day of MO-rCh 20�EXptns5aleNan7d29& - ����ExPlara:orloaer2r.rota Signature of Notary Public -�•^aontlMlNU Xohry Pubfr Nntlarmliera
U . V U