4116 FLEET LANDING BLVD PLUMBING CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 413M FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-1318
Job Type: PLUMBING ONLY
Description: 2 FIXTURES
Estimated Value:
Issue Date: 6/5/2015
Expiration Date: 12/2/2015
PROPERTY ADDRESS:
Address: 4116 FLEET LANDING BLVD
RE Number: LOC ID-0000
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BLVD
GENERAL CONTRACTOR INFORMATION:
Name: ASHLEY PLUMBING CO INC
Address: 11828 NEW KINGS RD STE 209
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $14.00
Trade Permit Base Fee $55.00
Total Payments: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
JL14-05-2015 20:45 From: To:19042475845 Pase: 115
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 /Fax(904)247-5845
IOB ADDRESS: � I I U r G If P+Idol r� r PERMIT N
JEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE of FIXrURE QTY TYPE OFF=RE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPEOFFrXTORE QTY TYPEOFFDUVRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink ,
Floor Sink - Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Hester
Other Fixtures Water Treating System
MISCELLANEOUS:
:i Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 seta of plans)
D Lawn Sprinkler System-Number of Heads O Well **
k4 S RWD Well Completion Form. Completed form to be submitted to tFe Building Department for final inspection.**
D Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that:have read
Lis application end know the same k be no and correct All provisions of laws ad ordinances governing this work will be complied with whether specified
n nut. The permit does not give authority to violate the provisions of any other sank or local law regulation conehucton or the performance of construction.
Property Owners Name FLEET LANDING Phone Number 904246-9900
Plumbing Company ASHLEY PLUMBING COMPANY INC. Office Phone 904-393-7959_Fax904399-0552
Co. Address: 542435 US Hwy I City Callahan_State FL_Zip 32011
License Holder(Print): CMSTQPBER S AS CertificationlRegistration til CFC057804_
Notarized Signature of License Holder
"+, Nathan P.Ttrdtaf Sworn and subscribed before me this 41 f J#I w �/S6. r
`° °:camieaa rff,s248s `>'jarG(aa/ /l •r--
,'EVrea:AUG 1A,2NO Signature of Notary Public