900 PLAZA #21 PLUMBING CITY OF ATLANTIC BEACH
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: 15-PLBG-510
Job Type: PLUMBING ONLY
Description: 3 FIXTURES UNIT 21
Estimated Value:
Issue Date: 3/13/2015
Expiration Date: 9/9/2015
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
Trade Permit Base Fee $55.00
Plumbing Fixtures $21.00
Total Payments: $80.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CRY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Mar 09 2015 08:49AM Empire 9047252257 page S
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: 900 PLI*ZA DR,ATLANTIC BEACH FL 32233 UNIT 71 PERMrr#
NEW OR REPLACEMENT INSTALLATION: Project Values
TYPE OFFIXTU# QTY TYPEOFFIXTORE 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 2_ Water Treating System
RE-PIPE:
TYPEOFFIXTUI(E 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 —
How Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater —
Other Fixtures I Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plana:
❑ Lawn Sprinkler System Number of Heads ❑ Well ••
SIRwD well Completion Form. Completed form to be submitted to a Building Department for final inspection."
❑ Other REPLACE TWO SHOWER VALVE, HOOK UP ONE WASHER MACHINE DRAIN LINE AND WATER
LINE
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that 1 have rea
thu application and know the same to be we and correct. All provisions of laws and ordinances governing this work will be complied with whether specimed
mnot The permit does not give eut�ority to violate the provisions of any other stat or local law regulation construction Or the performance of eoosruaioa
Property Owners Name SEA 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 HH)DE�GARDENS DR City JACKSONVILLE State Zip 32258
License Holder(Print): EMS Lukai State Certification//RR.eg`istration# CFC 1427347
Notarized Signature ofLlepnse Holder
i
Sworn and subscribed before me this day of 20_