5308 Fleet Landing Blvd PLBG 2015 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-224
Job Type: PLUMBING ONLY
Description: water softner
Estimated Value:
Issue Date: 1/28/2015
Expiration Date: 7/27/2015
PROPERTY ADDRESS:
Address: 5308 FLEET LANDING BLVD
RE Number: LOC ID-0000
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE, INC
Address: 1 FLEET LANDING BLVD
GENERAL CONTRACTOR INFORMATION:
Name: AFFORDABLE WATER/KINDER INC
Address: 3760 KORI RD SPECIALTY WATER (CONS TDS QB)
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $7.00
!1 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.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: 5306 ONIE FLEFT LANG 1"QC' i3 t J C1 PERMIT#
A+LAN 1-1 G Geo c_F"1
NEW OR REPLACEMENT INSTALLATION: Project Value $ �� ®a
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 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
Toilet
Floor Sink
Urinal
Hose Bibs Vacuum Breakers
Kitchen Sink Water Connected Appliances
Laundry Tray Water Heater - —
Lavatory Water Treating System _ --
Other Fixtures
MISCELLANEOUS: gallons(Requires 3 sets of plans)
❑ Sewer Replacement [i Back Flow Preventer F_ Grease Interceptor (Trap) g ( q
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ ther
s. I hereby certify that I have
r
becomes void if work does not commence within a Alim ov cioth ns of laws and ord naniod or work is o sdgoveror ning tha work wr six ill be complied with hether pecifiedd
this_,plication and know the same to be true and correct. p
or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performanc`e=ofacconstruction.
Property Owners Name FL.Er7 LANQ
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/1 nr.,.�,.,_h, �� Phone Number 9 04-'i 14�-
Plumbing Company A FFo R O A [� � v�lqT£2
Office Phone��Z-0 I`�1 Fax—:2-o6 10-to 2-9 Z
Co. Address: 3 r760 K o R 1 IZOA�
City�c KS L e o n u State FL Zip 3 2-2-5
License Holder(Print): I�A RIS f� Iii 11s
State Certification/Registration#
Notarized Signature of License Holder nu a ri4 20 I5
or Florida Sworn and subscribed bef e this a day of
e 854361 Signature of Notary P lic
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