122 FLEET LANDING 2015 PLUMB r 1J,<S, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
D
r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
.moi X131>
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-775
Job Type: PLUMBING ONLY
Description: INSTALL 2 FIXTURES
Estimated Value:
Issue Date: 4/2/2015
Expiration Date: 9/29/2015
PROPERTY ADDRESS:
Address: 122 FLEET LANDING BLVD
RE Number: LOC ID-0000
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BLVD
GENERAL CONTRACTOR INFORMATION:
Name: ASHLEY PLUMBING CO INC
Address: 11828 NEW KINGS RD STE 209
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $14.00
Trade Permit Base Fee $55.00
Total Payments: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
RPR-03-2015 03:09 From: To:2475845 Pa9e:4'5
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH �Q ` ,�
800 Seminole Rd Atlantic Beach, FL 32233 U S
Ph (904) 247-5'8_26 Fax (904) 247-5845
JOB ADDRESS: /09 tJ 1IJ PERMIT#
'-;EW OR REPLACEMENT INSTALLATION: Project value $
.TYPE o1~'FIXTURE QTY TYPE of FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower _
Dishwasher Shower Pan
ZE
Drinking Fountain Slop Sink
Floor Drain ' Three Compartment Sink
Floor Sink Toilet
Flose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatorq Water Heater
Other Fixtures Water Treating System _
: E-PIPE:
TYPE of FIXTURE QTY TYPE of FIXTURE QT'
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:
7 Sewer Replacement ❑ Back Flow Preventer o Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Lawn Sprinkler System-Number of Heads ❑ well **
f* &1RWD Well Completion Form. Completed form to be submitted to the Building; Department for final inspection.**
3 Other
'crmit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months, I hereby certi fy that I have read
tis application and know the same to be true and corroct. All provisions of laws and ordinances governing this work will be complied with whether specified
r not. 'I he permit does not give authority to violate the provisions of any other state or local law regulation vonstruction or the perlurmancc of construction.
'roperty Owners Name FLEET LANDING Phone Number 904-246-9900
'lambing Company ASHLEY PLUMBING COMPANY ! •=•O c lone 904-393-7959 _Fax904-399-0552
N,&
132011
;o. Address: 542435 US Hwy 1 City rAalian » ate FL zip
.icense Holder(Print): CHRISTOPHER S SHLEY St CeitWication/Registration# CFC057804_
notarized Signature of License Holder
f4 -
`"'ph•, Nathan p.Tucker � , _da of
.' ;.Coi�,lael #FFI52435 Sworn and subscribed befo e. to this; Y
Exlrres:AUG 19,20`18 Signature of Notary Public •
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