1765 MARITIME OAK DR - PLUMBING S1
CITY OF ATLANTIC BEACH
j 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-1256
Job Type: PLUMBING ONLY
Description: 25 fixtures new service
Estimated Value:
Issue Date: 5/29/2015
Expiration Date: 11/25/2015
PROPERTY ADDRESS:
Address: 1765 MARITIME OAK DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: NELSON PLUMBING CO. INC.
Address: 11624 -1 DAVE DAVIS CREEK RD QA 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 PERNM APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
11 Ph(904)247-5826 Fax(904)247-5845 /�
JoBADDREZ: 17ta55 Ma,,;4- rrtG DQJCS dJrIVG PERMIT# )5—StY')Ot13
NEW OR REPLACEMENT INSTALLATION: Project Value s
TYPE oFFMURE QTY TYPE oFFEaVRE QTY
Bffihtub =Tank&Pit
Clothes Washer Shower _.,3_—.
Dishwasher J— Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hoss:Bibs Urinal
Kitchen Sink �_ Vacuum Breakers
Laundry Tray _I— Water Connected Appliances Z
IsvamrY /a _ Water Heater
Odter Fixtures Water Treating System
RF,PIPE:
7TPEOFFbavRE QTY TYPE oFFbTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Sliower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bros Urinal
Kitchen Sink Vacutm Breakers
Laundry Tray Water Connected Appliaooes
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
O Sewer Replacement ❑Back Flow Preventer ❑ Grease Interceptor(Trap)_gallons(Requires 3 sets of plans:
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
•*SJRTVD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.*'
❑ Other
Pmmit becomes void ifwork does not comm®w within a six month pciod or work is suspended or abandoned for six aumtlu I hereby certifytbat I taw rea
thisapplicarimandkmwthemmembetrueandmrrecc All provisions oflaws and ordinmo governors this work will be compiled with whether specified
ormt. the permit does mt Ave authority to violate the provisions ofmY other state pa
or local law regulation construcdm"the Snmmm con
ofsavction,
Property Owners Name P ;yenlde H mfr Phone Nmriber90LM -7055
Plumbing Company - office Phone q04 XA;L AAFax 7J
Co.Address. I hg2i4- City i State fj,Zip
I,• CONe�b Scation/Itegisn #rF('ation 02n379
N ti BASS AQ
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' dd�ErfEpirea Nov la,N21001 m before e of 20�
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eonaes xaioaa xmary Aaa. ture of Notary Public