900 PLAZA #135 PLBG t 'I
j'% '\' ,/".l J
CITY OF ATLANTIC BEACH
S11 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
J INSPECTION PHONE LINE 247-5814
F'
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 14-PLBG-641
Job Type: PLUMBING ONLY
Description: UNIT#135, INSTALL 3 FIXTURES
Estimated Value:
Issue Date: 12/17/2014
Expiration Date: 6/15/2015
PROPERTY ADDRESS:
Address: 900 Plaza
RE Number: 171725-0500
PROPERTY OWNER:
Name: SEA OATS ACQUISITIONS, LLC
Address: 645 MAYPORT RD SUITE 5 645 MAYPORT ROAD SUITE 5
GENERAL CONTRACTOR INFORMATION:
Name: FLORIDA EMPIRE PLUMBING INC
Address: 5358 HIDDENS GARDENS DR QA ELVIS K LUKAJ
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $21.00
Trade Permit Base Fee $55.00
Total Payments: $80.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
Jos ADDRESS:
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE Qom'
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 c Water Treating System
RE-PIPE:
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 __L__ Water Treating System
MISCELLANEOUS: allons(Requires 3 sets of plans)
Sewer Replacement ED Back Flow Preventer ❑ Grease Interceptor(Trap) S
Lawn Sprinkler System-Number of Heads ❑ Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Otim� GC
read
Permit becomes void if work does not commence within a six month
of o lawsandi suspended
or abandoned
this foor kxvill behcompliedywith whether speccertify that I efied
this application and know the same to be we and correct. All provisions
or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performanceconstruction.
Phone Number �!
Property Owners Name
____Office
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Co. Address: �����
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License Holder(Print): �lz'' `� State Certification/Registration 4 4,�Y ��•�
Notarized Signature of License Holder r
Sworn and subscribed efore me this day of 20
Signature of Notary Public