1585 PARK TER E - PLUMBING ° 1* •S, CITY OF ATLANTIC BEACH
, ryA, J 800 SEMINOLE ROAD
r: = _,� 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-3835
Job Type: PLUMBING ONLY
Description: PLUMBING - SEWER REPLACEMENT
Estimated Value: $1,194.00
Issue Date: 4/25/2017
Expiration Date: 10/22/2017 _
PROPERTY ADDRESS:
Address: 1585 E PARK TER
RE Number: 171957-0000
PROPERTY OWNER:
Name: CROFT, ROBERT W & EILEEN P, *
Address: 1585 PARK TER
GENERAL CONTRACTOR INFORMATION:
Name: ROTO ROOTER SERVICES
, CFC 057629
Address: 2028 W 21ST ST
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: $66.00
,:s1
?� PERMIT IS APPROVED ONLY IN ACCORDANCE wan ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
;, BUILDING CODES.
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PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904)247-5826 Fax (904)247-5845 I`7 P L e G 3 E35
JOB ADDRESS: /6?6 PA-QK- Tie--e-ie A CZ-- �= PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ 1, /9`, 00
TYPE OF FIXTURE Q7'1' 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 Q7'1'
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:
i i'Sewer Replacement 0 Back Flow Preventer 0 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.**
0 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 tnte and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The pennit does not give al°rity to violateth provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name /C(2664-74-T Phone Number 90J�SO�
Plumbing Company / O7?2 o0-7. OfficerPhonego�3.5� 73�/ Fax 90 35�9.75�
Co. Address: &de' iiJ o2I.ST
License Holder(Print): Citi A )✓'' State " Zip 3-240?��2.E�(,�/ �v74-
State Certification/Registration # 0514'-?9Notarized Signature of License Holder ��OLI �v�
Sworn and subscribed before me this 026- day of 4PR.J4-- 20
NI t
�'K'•4 KAREN S.JUNGKLAUS /�
7 m ` Commission November
297 Signature of'Notary Public �J -�
�:.r. Expires November 25,2018
.o'� Bondd llw Trod FUN Ywv eQpJpi7019