22 SARATOGA CIR - PLUMBING , `r ,- Jam;'.
✓ \S f CITY OF ATLANTIC BEACH
J
',..a,, 5-) 800 SEMINOLE ROAD
J y ` _X ATLANTIC BEACH, FL 32233
/ INSPECTION PHONE LINE 247-5814
\J;;1 9r
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-PLBG-3728
Job Type: PLUMBING ONLY
Description: PLUMBING -12 FIXTURES
Estimated Value:
Issue Date: 4/11/2017
Expiration Date: 10/8/2017
PROPERTY ADDRESS:
Address: 22 N SARATOGA CIR
RE Number: 171813-0000
PROPERTY OWNER:
Name: SEC Holdings LLC
Address: 209 Deer Haven DR
GENERAL CONTRACTOR INFORMATION:
Name: WAYNE CONN PLUMBING INC.
Vernon J. Sparks, CFC1428564
Address: 6915 W BEAVER ST
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $84.00
Trade Permit Base Fee $55.00
Total Payments: $143.00
PERMIT 1S APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH n
800 Seminole Rd Atlantic Beach,FL 32233 / 7-r' - a C `-7 Z P'
Ph(904)247-5826 Fax(904)247-5845 / 7_fQ/9-m_
JOB ADDRESS: �,?,Z 5-',A/�•7`'67it ----71 PERMIT# ).7
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE Qn'
Bathtub 1 Septic Tank&Pit
Clothes Washer / Shower
015
Dishwasher / Shower Pan 1______
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 .a Water Heater _7
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE QT 0 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 :-,,'
MISCELLANEOUS:
❑ Sewer Replacement 0 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.**
❑ 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 loc law regulationcconstkuJ tio�s performance of construction.
Property Owners Name 57/" "//-e 44OI��Z�Y s e C ttPhone Number
Plumbing CompanYI), �'e GOA/ // .0"/, Office Phone. J-,1/s < Fax
Co. Address:67/5-- %2 �a-e•._ '.0±-. City' State Zi
License Holder(Print): �AA/ c, Aopz.. e_$ State Certification/Registration# f.?.Gt
Notarized Si:na . • ,.____1-,.. Holder 1X
4.",''•,, TONI GINDLESPERGER l l da O ` 20 ��
p MY CCMM!SS!GN FE 924951 Before me this
": * '` EXPIRES:October 6,2019
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.;:-...1-1%.14:;
�: °= Notary Public Underwoters • S
;f,r Bonded n Signature of Notary Public ,