2251 Barefoot Trace plbg permit �,S I
CITY OF ATLANTIC BEACH
r 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
r�
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
708 INFORMATION:
lob ID: 17-PLBG-3574
lob Type: PLUMBING ONLY
Description: PLUMBING - 7 FIXTURES
Estimated Value:
Issue Date: 3/24/2017
Expiration Date: 9/20/2017
PROPERTY ADDRESS:
Address: 2251 BAREFOOT TRAC
RE Number: 169463-0632
PROPERTY OWNER:
Name: HAGAN,KENNETH DALE & CATHRYN A,
Address: 2251 BAREFOOT TRAC
GENERAL CONTRACTOR INFORMATION:
Name: MIKE SANVILLE PLUMBING INC
,CFC057340
Address: 530 ELLIS RD STE 212 QA MICHAEL RAYMOND
SANVILLE,II
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $49.00
Trade Permit Base Fee $55.00
Total Payments: $108.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORHIA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 17 - PL&C-A-3574
Ph(904)247-5826((`` Fax(904)247-5845
JOB ADDRESS: Z zS I a a r e-4- 4— PERMIT# �/
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE of FIXTORE QTY TYPE of,FTRTDRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor SinkToilet cZ
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry TrayWater Connected Appliances
Lavatory —'� Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE orFLYTURE QTY TYPE oFFErmRE 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 SinkVacuum Breakers
Laundry TrayWater Connected Appliances
LavatoryWater 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 withina sin month period or work is suspended or abandoned for six nionths.I hereby cat fy drat I have read
this application and know the same to be true and correct All provisions of laws end 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 constmction.
Property Owners Name�"-E mar Phone Number L+ p
Plumbing Company 'l'ro �_ .,, r 7 le- ���� Office Phone30Y &11 Flax O r�77J s�
Co. Address: Q r City" State ( �[ ZiplVe
License Holder(Print): i /I i/i Star Certificatio gistration# d .7
Notarized Signature of Liceme Holder
; =E1
Before me this day o 20
17
4�1992`yreR Signature of Notary Public
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