532 Atlantic Beach Ct plbg prmit SSI;
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
. Ir
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-2520
Job Type: PLUMBING ONLY
Description: install 31 fixtures
Estimated Value: $5,000.00
Issue Date: 11/9/2016
_ Expiration Date: 5/8/2017
PROPERTY ADDRESS:
Address: 532 ATLANTIC BEACH CT
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: NELSON PLUMBING CO. INC.
Scott Nelson,CFCO20379
Address: 11624 -1 DAV E DAVIS CREEK RD QA SCOTT GARY
NELSON
Phone: -
FEES:
Plumbing Fixtures $217.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $276.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-55826 Fax(904)247-5845
JOBADDRESS: 532 n
An-Awic ISVA[R CT PERMIT# Ib-$FR-Zi�f
NEW OR REPLACEMENT INSTALLATION: Project Value$ .5000
TYPE of FIXTURE QTY TYPE oFFLYTURE QTY
Bathtub Septic Tank&Pi[
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet —�
Hose Bibs _3— Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater —I—
Other Fixtures Water Treating System
RE-PIPE:
TYPE oFFixTuRE 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:
❑ Sewer Replacement o Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well •'
**S ,RWD 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.1 hereby certify that I have read
this application and know the same to be one 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.
Properly Owners Name AW ei&j, Phone Number
Plumbing Company AlaSbi t c4mj?146 PD 2P Office Phone UZ V96 y Fax
Co. Address: 1162N - ( DPV(s (_111744,k. BA E CiTy '3 Vr State 'tel Zip 322�6
License Holder(Print): D LSO Certification/Registration# OZO&'7R
Notari a older
W c"ISsloN rRIF 9om+9 Before me this day of Vel
�. E
EXPIRES'Nwembar i6,2D'9
�,d.ernmxourweewrMlwr Signature of NotaryPubli