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5107 Fleet Landing PLBG CITY OF ATLANTIC BEACH ' Ss� 800 SEMINOLE ROAD 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: 14-PLBG-697 Job Type: PLUMBING ONLY Description: 1 fixture Estimated Value: Issue Date: 12/23/2014 Expiration Date: 6/21/2015 PROPERTY ADDRESS: Address: 5107 FLEET LANDING BLVD RE Number: LOC ID-0000 PROPERTY OWNER: Name: NAVAL CONTINUING CARE Address: 1 FLEET LANDING BLVD GENERAL CONTRACTOR INFORMATION: Name: DAVID GRAY PLUMBING INC. Address: 6491 S POWERS AVE QA DAVID FRED GRAY 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 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Mar 08 10 12:54P Information SystemsCr y 0 904247-5845 P•1 PLUMBING PERMIT APPLICATION CTI Y OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach,FL 32233 Ph(904) 247-5326 Fax(906)247-5545 M3 ADDRESS' PFRmrr NEW OR REPLAr 72*fE dT INSTA-LLATION: Project VAUle $ TYPE OF FixruRE QTY TYPE OF FUTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower ;Dishwasher Shower 11an „inking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Dims Urinal Kitchen Sink. Vacuum Breakers Laundry Tray Water Connected Appliances —�— Lavatory Mater Heater -Other'Fbdures Water Treating System RE-PIPS: T`Y-FE oF FDffz-TF QTT TYF-E OF FLOUR E QT' BathtubSeptic Tank&Pit Shower Clothes Washer Dishwasher Shower Pan Drinking Fountain Slop Sink rain •- -• Three Compartment Sink Floor D Floor Sink Toilet Hose Bibs Vacuum Sink Vacuum Breaker Kitchen Sin Laundry Tray k Water Connected Appliances Lavatory Water Heater CQther Fiztures Nater Treating System MISCELLANEOUS: gallons(Rer;uirw � sets of p? ❑ Sewer Replacement C3 Back Flow Pre-venter ❑ Grease interceptor(Trap) g ❑ Lawn Sprinkler System-,Tumber of Heads ❑ Well ' — SIRWD Well Completicin Form. Completed.form to be submitted to the Building Departneni for final inspection.=� ❑ Other. ?omit becomes void if wor'.c does not commence within a six month period or work is suspended or abandoned for six months.I hereby c--rtifv that I have rrzd this application and]mow the same to be true and correct. Al provisions of Saws and ordinances gover.mng this vi or.will b-e can: 13ed with whether specifi,d or not• The permit does not give authority to violate the provisions of any othrr sista or local la+x regulation construction or the performance of construc icn. Property Owners Name l 'L A Phone N=ber -` Pllbin Companypal G'f ` lt' 9918, Linc. O;fice Phone 7 Fax _`��-�� f4mare ourt Co. AddState ress: _ _ ;" City yip License Holder(Frit.);�yJs� 6� m State erti*3catianlRegistratior±9- C Notarized JaY3lPSAtare of Lieense HahieT Swom and subscribed before me tIns 22!--'�L da f of �44Cer'/,� 20_3_ Signature of Notary Pubtic �Ct, Y Notary Public State of Florida LaSheica Wilson My Commission EE050523 Expires 01/04/2015