1751 ATLANTIC BEACH DR PLUMBING CITY OF ATLANTIC BEACH
r) 800 SEMINOLE ROAD
!9 =5 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-1257
Job Type: PLUMBING ONLY
Description: 25 fixtures new service
Estimated Value:
Issue Date: 5/29/2015
Expiration Date: 11/25/2015
PROPERTY ADDRESS:
Address: 1751 ATLANTIC BEACH
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: NELSON PLUMBING CO. INC.
Address: 11624 -1 DAVE DAVIS CREEK RD CIA SCOTT GARY
NELSON
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $175.00
Trade Permit Base Fee $55.00
Total Payments: $234.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: 1751 "rrlie dead, Dr. PERMIT# I5-5FQ-817
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPEOFFDavRE QTY TYPEOFFvavPE QTY
Bathtub a Septic Talc&Pit
Clothes Washer
Dishwasher �I_ ShowerPan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet _
Bose sibs Urinal
Kitchen
Vacuum Breakers
Laundry Troy y Water Connected Appliances I
Lavatory Water Heater
Other Fnlures Water Treating System
RE-PIPE:
TYPEOFFn7vRE QTY TYPE OFFvavRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Showa
Dishwasher i SBower Pan
Drinking Foimtam Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bros Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Wan Connected Appliances _
Lavatory Water Heater
Otter Fi stares Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans
❑ Lawn Sprinkler System-Number of Heads ❑ Well . **
** VRWD Well ComWlerion Form.Completed fort to be submitted to the Building Department for final inspection.*
❑ Other
Pe®it bccuma wid if work docs not commence within a six month period m work is mmpmxW or abeadmedfor she mouths l hereby testify that I have rete
thisapheatimamdknmthe membemreadmrtca. All pmviioos of lam and mdmaaca®ovaamBthiswork wilt be complied with whetha specificd
u not the pcoaitdoes not give aundiorhy m violatcthe provisions of any otha sate or local lawregalstion w=rcd1m mthe pafamsnucanae Ofwnw
Property Owners Name h1Yet-SIdC �6fOGS Phone Number 404'503-7055
Plumbing Company NP.I50n �)UM II _OfficePhone96=1,2W-t7Lf4 Fax904-8&9731
Co.Address: Iltoa4'I Dav;s rrelk E ci Jock.4a,yillP Stata?-EL-zip .32a5b
�j p 1 er(Print : S CerocationlRegisua ion#/FG 0203 7q
O — S• any a I¢gate a1 Floritla
i ;My comm.E Pn.No,16.2015 Swom and subscribed before me2d'�
EZJ 14
Commission*EE 13]4]5iE
P6nded Tdmuga National Notary Assn. Slg[uatme of Notary Pubh