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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 •2 My�CaLT-1roqh ' dd�ErfEpirea Nov la,N21001 m before e of 20� �? Coloa M EE 17747and MbSCO 5 eonaes xaioaa xmary Aaa. ture of Notary Public