1132 LINKSIDE DR - PLUMBING 116
,� �y ,, ` s, CITY OF ATLANTIC BEACH
r. 800 SEMINOLE ROAD
j 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-3784
Job Type: PLUMBING ONLY
Description: PLUMBING - 6 FIXTURES
Estimated Value: $1,300.00
Issue Date: 4/18/2017
Expiration Date: 10/15/2017
PROPERTY ADDRESS:
Address: 1132 LINKSIDE DR
RE Number: 172374-5020
PROPERTY OWNER:
Name: Armour, William
Address:
GENERAL CONTRACTOR INFORMATION:
Name: KURT JACKSON PLUMBING INC
, CFC 057103
Address: 1541 Lasota AVE
Phone: 904-566-5099
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $42.00
Trade Permit Base Fee $55.00
Total Payments: $101 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 2
Ph (904) 247-5826 Fax (904) 247-5845 ) 7 --P L 6C ' 3 784
JOB ADDRESS: // 3 Z---/2-7 -:5-/6-1E- PERMIT# %7/f,11hYL
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NEW OR REPLACEMENT INSTALLATION: Project Value$ / 5O 0-CO
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub __ _ Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan _L__
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink _1_ Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory ‘.0 Water Heater
Other Fixtures Water Treating System
RE-PIPE: U
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
MISCELLANEOUS:
o Sewer Replacement u Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
o Lawn Sprinkler System-Number of Heads ❑ 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 IN Z kl i Ok- - i4 V' VY o/ Phone Number
Plumbing Company AA ✓/ �G{(,.41 l(.e )14.6'H . . f'J� Office Phone QDq 51045CM Fax
Co. Address: 15(1/ t a se r .— City 4Qkrvii! Stater"(. Zip 339b5
License Holder(Print): '7"-'-kvUvia,3 le-< Waci-c-- tate Certification/Registration# Cr-C-05-7/D 3
Notarized Signature of License Holder
--„ • , Sworn and cribed before this I :a . . of �I * 2d
•.�x 70NI GINpLESPERGER
?` ' ' MY COMMISSION 4 FF 524951
a EXPIRES:October 6,2019 Signature of Notary Public .
- ,d0. Bonded Thru Notary Publi:Underwriters