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]