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610 TIMBER BRIDGE LN - PLUMBING -�Jr\I'1 j. Jr ,;t CITY OF ATLANTIC BEACH f ' � 800 SEMINOLE ROAD 1J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 �I�l�r PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-PLBG-1797 Job Type: PLUMBING ONLY Description: new plumbing 27 fixtures Estimated Value: Issue Date: 7/29/2015 Expiration Date: 1/25/2016 PROPERTY ADDRESS: Address: 610 TIMBER BRIDGE LN 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 $189.00 Trade Permit Base Fee $55.00 Total Payments: $248.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA 41 BUILDING CODES. PLUMBING PERMIT APPLICATION , i CITY OF ATLANTIC BEACH ; V 800 Seminole Rd Atlantic Beach,FL 32233 ` Lilo Ph(904)247-5826 Fax(904)247-5845 y JOB ADDRE S: RA •.". 1. II. ' . i.../ ' PERMIT# J5-5FR-t 5 I NEW ORREPLAONT INSTALLATION: Project Value$ TYPE OF F JRR QTY TYPE OF FIXTURE QTY Bathtub 7 Septic Tank&Pit Clothes washer Shower I D--•washer Shower Pan ;, , Fountain Slop Sink • F ' Drain Three Compartment Sink Flan, Sink Toilet 5 Ho..- Bibs Ural K. .'en Sink — dry Tray Vacuum Breakers Water Connected Appliances T—r- . : fixtures , Water Heater `-`7T'-_.--- - Water Treating System ) /�/� RE-PIPE: -r OF FIXTURE • an TYPE OFFIXTURE QTY. Ball • . Septic Tank&Pit Clothes Washer _ Shower -.i , : .er Shibwer Pan r f. .:1. . Fa • twin Slop Sink F .. Aram Three Compartment Sink Floc Sink Toilet .: Bibs Urinal '• .` j" Sink Vacuum Breakers L' • . Tray Water Connected Appliances Lay: r. Water Heater • ,4 zo Fixtures Walla.Treating System MVIISCEL • ' ' OUS: o Sewer Replacement la Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans. o Lawn Sprinkler System-Number of Heads 0 Well . ** **SaWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.*' O Other • Permit becomes void if work does not commence within a six mouth period or work is suspended or abandoned for six monk] hathycertifyitic have rca. this application and lmow the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether speaficd or not The permit does not give authority to violate the provisions of any other suite or local law regulation construction or the perfozmanec of construction. Property Owners Name brni.AY3 Pho Number • _ Plumbing Con ny .k '. . *• _- • •r o I 0 i. • Phone -48 Faxgo'- 8,93-873( Co.Address: - �I ;, ••.• ��/// I jaCkASOnV i 116 State FL Zip 3,2a 56 License Bolder ' .t): C a■ I - swift ,I,) eertif catian�egi�ration# _ G f��3 7 """. LISA P BASS t 1/ r V V ,` =, Notary Public-State at Florida 'WM and subscribed before me rt'. _ day of (�,� 5 : - =.My Comm.Expires Nov 16,2015 y 20 %.,r4;:,it I +�•; Commission#EE 137475 •r Notary Public " ;N°"� Bonded Through National Notary Assn, w�� • ^� ` � . . j PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 247-5826 Fax (904)247-5845 JOB ADDRESS: 16o/O) ! /n bor Zr lc Lail P PEi&rrr# 15-S F R-15a� NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE OF FIXTURE QTY TYPE OF FIXTURE Qn' Bathtub 5 Septic Tank&Pit Clothes Washer I Shower Dishwasher _L_ Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink I Vacuum Breakers Laundry Tray 1 Water Connected Appliances / Lavatory Lo Water Heater I Other Fixtures Water Treating System __/- RE-PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE 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 MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans ❑ Lawn Sprinkler System-Number of Heads ❑ Well ** ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.* ❑ 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 I have rea this application and know the same to be true and correct All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name brOwn Phone Number Plumbing Combany N to jSUr ?)6(11-7 binr Co ITYIG O:.ce Phoneq -/- a(aa_u&E/FaxgOq- ffa3-873(0• Co.Address: ,, - I 10 /t 1 Jacksonv i Ile State FL. Zip 3<%2 5(0 License Holder (Print): C • i , • n/1j�l,��l ''-te Certification/Registration#(AFC Qz,37q Nowr zeds„,,,,atj,rB 4Liras.,cur rr-+lderk /j/'��4I/'/ ,'';fib LISA P. BASS , /I� �.`�'; Notary Public-State of Florida sworn and subscribed before me .•. O — day of �� • �� • 1• My Comm.Expires Nov 16,2015 y 20 15 � ;r» Kira . Q: ;,,.-1- �; Commission # EE 137475 4ignature of Notary Public j'- ''''' Bonded Through National Notary Assn. ! ti� �'