967 ATLANTIC BLVD- PLUMBING s\ CITY OF ATLANTIC BEACH
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� 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-3674
Job Type: PLUMBING ONLY
Description: PLUMBING - WATER HEATER
Estimated Value:
Issue Date: 4/4/2017
Expiration Date: 10/1/2017
PROPERTY ADDRESS:
Address: 967 ATLANTIC BLVD
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: METRO ROOTER
, CFC052702
Address: 8892 NORMANDY BLVD QA THOMAS ALLEN
MCLAUGHLIN
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $7.00
Trade Permit Base Fee $55.00
Total Payments: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845 17— P L B G-- 37'4
JOB ADDRESS: 967 ATLANTIC BLVD ATLANTIC BEACH, FL 32233 PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE 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
RE-PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE 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 x
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 0 Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
o 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 I have read
this application and know the same to be true 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 any other state or local law regulation construction or the performance of construction.
Property Owners Name CULHANES IRISH PUB Phonc Number 249-9595
Plumbing Company Certified Environmental Svcs Inc D/B/A Metro-Rooter Office Phone 904-695-1911 Fax 904-695-1800
Co. Address: 8892 Normandy Blvd City Jacksonville State FI Zip 32221
License Holder(Print): Tom A. McLaughlin 1 State Certification/Registration# CFC052702
Notarized Signature of License Holder ��,�,4.
NIII11%
Sworn an. '.scribed before this 4 c
day of*ell
20/7
s V MARY H ion#FF Signature of Notary Public /
:.. ��, :.: Commission#FF 026041
:i..� 1 Expires October 11,2017
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