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900 PLAZA #94 PLUMBING . ?f�IJrn .� V CITY OF ATLANTIC BEACH rI 800 SEMINOLE ROAD J 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: 15-PLBG-505 Job Type: PLUMBING ONLY Description: 2 FIXTURES UNIT 94 Estimated Value: Issue Date: 3/13/2015 Expiration Date: 9/9/2015 PROPERTY ADDRESS: Address: 900 Plaza RE Number: 171725-0500 PROPERTY OWNER: Name: SFA 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 $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. Mar 09 2015 Oa:4sAM Empire 9047252257 page 3 PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Sentinole Rd Atlantic Beach,FL 32233 Ph(904)247-5826 Fax (904)247-5845 JOB ADDRESS: 900 PLAZA DR,ATLANTIC BEACH FL 32233 UNIT PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value S TYPE OFFIXTOttia QTY TYPEOFFIXTGRE QTY Bathtub Septic Tank,&Pit Clothes Washer Showcr Dishwasher Shower Pan Dritddng Fountaid Slop Sink Floor Dmm Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink ! Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Odier Fixtures I Water Treating System RE-PIPE: TYPEOFFIXTOI�E QTY TYPEOFFIXTORE QTY Bathtub Septic Tank&Pit Clothes Washer ', Shower Dishwasher Shower Pan Drinking Founmhj 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 1_ Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ r aek Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans ❑ Lawn Sprinkler System-dumber of Heads ❑ Well •* *•SJR WD Well CompleNo#t Form. Completed form to be submitted to the Buil ng Department for final inspection. ❑ Other REPLACE ONE SIHOWER VALVE, HOOK UP ONE WASHER MACHINE DRAIN LINE AND WATER LINE Permit becomes void if work does nor commence within a six month period or work is suspended or abandoned for six months.I hereby certify that 1 have reg this application and know the same m be one and correct All provisions of laws and ordinances governing this work will be complied with whether specifier or out. The permit does not give authority to violate the provislons of any other since or lural law regulation construction or the performance of construction. Property Owners Name SIA OATS ACQUISITIONS Phone Number 904-246-6474 Plumbing Company FLORIDA EMPIRE PLUMBING,INC Office Phone 904-465-2538 Fax 904-725-2257 Co. Address: 5358 HIDDEN GARDENS DR City JACKSONVILLE State Zip 32258 License Holder(Print): EMs Luka' State Ceitifi'ccaation/RcgJJistr'aation 4 CFC 1427347 Notariud Signatwre of Licimure HoMer Sworn and subscribed before me this day of 20_