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5411 CAPELLA CT WATER SOFTNER 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-1313 Job Type: PLUMBING ONLY Description: water softner Estimated Value: Issue Date: 6/5/2015 Expiration Date: 12/2/2015 PROPERTY ADDRESS: Address: 5411 CAPELLA CT RE Number: LOC ID-0000 PROPERTY OWNER: Name: NAVAL CONTINUING CARE RETIREME Address: 1 FLEET LANDING BLVD 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 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 JOBADDRESS• 5411 CAPELLA CaukT, ATLANTIC $EACH PELT# NEW OR REPLACEMENT INSTALLATION: Project Values (4,00 TYPE OF FIXTURE QTY TYPEOFFIXTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drinking SlopSink oFountain Drain ThCompartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Futures Water Treating System RE-PIPE: TYPEoFFIXTORE QTY TYPE oFF/XTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Flom Sink Toilet Hose Bibs — Urinal Kitchen Sink — Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater _ Other Fixtures Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 seta of plans) ❑ Lawn Sprinkler System-Number of Heads ❑ Well ++ +*SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. 0 Other Permit be:th oid if work does ant commence within a six month period or work is suspended or abandoned for six months.I hereby canfy that I haw read this applind know the same to be not and coned. All provisions of laws and ordinances governing this work will be complied with whether specified or not Thit does not give authority m violate the provisions of any otic state or local law regulation construction or the performance of cam uction. Properners Name ROBERT K11.5 �rl4e+ Lanclinrr ) Phone Number Plumbimpany A FFO RDAAL£ WAT£2 OfficePhones 2J/ 2-019'1 Fax2-e-o-tp29Z Co.Ad : 3r7GO KoRi ROAD City%�'KSOO6,lie StateEL ZipLicensder(Print): A C��tion/Itegisttation# �8ISin Notarkgnature ojl' Holder y M Dere romrSwom and subscribed bef a this 21 day of IY) y 201M M Devote/ mmsronEE864e81 Signature of Notary tic�qrCr a29pr1a1]