2139 SEMINOLE RD - PLUMBING r„ p !f .AL. �S
, CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
KV ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
`�J1i1Wr.
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-2879
Job Type: PLUMBING ONLY
Description: 14 FIXTURES
Estimated Value:
Issue Date: 12/14/2015
Expiration Date: 6/11/2016
PROPERTY ADDRESS:
Address: 2139 SEMINOLE RD
RE Number: 169515-0500
PROPERTY OWNER:
Name: SCHAFFNER, MARY ANN
Address: 2139 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: STEEG PLUMBING
Address: 1601 MAIN ST QA JAMES STEEG
Phone: -
-
FEES: ---- ---
Trade Permit Base Fee $55.00
Plumbing Fixtures $98.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Total Payments: $157.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
,. CITY OF ATLANT.IC BEACH .
800 Seminole Rd Atlantic Beach; FL 32233
Ph(904) 247-5826 Fax(904) 247-5845
G -7- • PEA
•
:h' :f OR.REPLAC£IV "aNT INSTALLATION: Project Value$
TYPE OF Fixrurz Ore TkrE OFF FEMME • OTY
Bathtub • Septic Tank&Pit
Clothes Washer • Shower
Dishwasher • Shower Pan
Drinking Fountain Slop Sink
Floor fain
•
Three Compartment Sink /
Floor Sink Toilet
. Hose Bibs • Urinal
Kitchen Sink t C Breakers
LLaundry Tray Water Connected Appliances •Lavatory - Water Heater
•
Other Fixtures • Water Treating System
RE-PIPE: • .
TYPE OF FUTURE Orr TYPE OFF.iTf1RF OzY
Bathtub Septic Tank&Pit
•
Clothes Washer • Shower •
Dishwasher . Shower Pan
Drinking Four in • Slop Sink
Floor Draw Three Comparinent Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink V acur i m Breakers •
Laundry Tray Water Connected Appliances .
Lavatory _ Water Heater •
Other Fixtures Water Treating System
MISCELLANEOUS: .
Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor(Trap) • gallons(Requires 3 sets of Pia`
A
Lawn Sprinkler System-Number of Heads u -Well
SIR WI) 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 moms.is hereby Cam"- `h a .
his appiicztioa and i ow the same to be true and correct. All provisions of laws�.d o:di�nances governing this work will be complied with of��C o
0r,ot. Tae permit does not give authority to violate the provisions of any other 5�e or local law rregoiavoa cocssac ion or the perforncaa
Pi7Operty Owners Name ./ Y 3 Phone e Number
_____________L—
Plumbing Company i / / / .r.0 Ofxce Phone 2y !..P_V Fax___ —
r i� City (A --State��Zip s �?' 3
Cc. Address: ��� � 5� ��G�3��
License Holder(Print): aI M ' * I State Certiacatiot/Reesuation#
day 20_
Swo."'ti, aix(i. �bscribeu bezor-m � t `- —
Signature of Notary Public M■�---- - •