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275 SAILFISH # 225 PLUMB 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 ]OB INFORMATION: Job ID: 15-PLBG-1874 Job Type: PLUMBING ONLY Description: 5 FIXTURES UNIT 225 Estimated Value: Issue Date: 8/5/2015 _Expiration Date: 2/1/2016 PROPERTY ADDRESS: Address: 275 SAILFISH DR RE Number: 170579-0000 -- PROPERTY OWNER: Name: PETERSON TRUST, TERRY LEE Address: 1500 SELVA MARINA BLVD GENERAL CONTRACTOR INFORMATION: Name: ATLANTIC COAST PLUMBING CORP. Address: 3653 REGENT BLVD APT 305 QA NICHOLAS ARLON PARRISH Phone: 904-997-3278 FEES: State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Plumbing Fixtures $35.00 Trade Permit Base Fee $55.00 Total Payments: $94.00 ANCES AND THE FLORIDA IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDIN BUILDING CODES. 03%05/2015 09:31 FAX 9046459363 atlantic-coast 001 1 V� PLUMBING PERMIT APPLICATION MY OF ATLANTIC BEACH 800 Semitlole Rd Atlantic Beach,FL 32233 Ph(904)2474926 Fax(904)247-5945 lI J I r 02, 6— NEW Z6— NEW OR WLACEMENT YMA1t,1.ATtC N: Project Value s TYPE oFFrx v*E' QTY Tr"OrrL m QYv Bathtub Septic Tank&Pit .— Clodo Washer swwcr W-- Dishwasher Shower pat+ — Drinking Fowtialn ,,,.^ Shp Sink — Floor Drain Thtve Compartment Sink Floor Sink Toilet Hose Bibs Urinal KIWI=Sink Vacuum Breakers .,,.,,. Laundry Tray Water Connected Applinnow Lav007 water H=Mw _. Flxtamm Water Treating System �..... RE-PIPE: 7 YP_of,FIXTURE QTY YvPE ofFaTURE Q77 Bathtub 6 Septic Tank&Pit Clothes Washer Shower — Dishwasher Shower Pan Drinking Fountain Slop Sink -- Floor Drain ter, Tht,e e c mpartmeot Sink Floor Sink Toilet ��.. Hasa Bibs Urinal _.. Kitchen Sink Vatcuum Brcaktxa Laundry TrayWow Connected Appliances Lavatory W Wow HOW �— Odw Fbetures _� Wow Treating System MISCELLANEOUS: ❑Sewer Replacement ©Back Flow Preventer D Orewc interceptor(Trap) sellers(>Regnirex 3 sets of pians) ❑ Lgwn SprjWdAr Systow-Number of Heade q Well ;+ SlRWD Well Completion Form.Compk irm to be submitted to di Zdng Department Lbr final inspection.+� C3 othat tt�a■ Permit becomes void if work dans not eomntptce n sax north period or work is suspended or abet► x*4 for silt months.l hereby ca that I have head this application Ind know d►o 9*m ta be u w W eoerc. All pnwWoes of holt NW Ordlemeoes aovmy+in8 this week will be eoan{alidd witA v+hdtllnT 1poaitied or wL The paratit does rat blva AwJwtity to*Uffio ttte of nay 0*cr MW or iow taw OwAstim construeem or lila prCatteume ormamuWDIL Property Owners Name M / k ms L i 1\1 Phone Number xZ�6 7 Plumbing company �Ofr=phone Co.Address: � � City �i l�-�C • State zip Liecusc Holder(Print): ez, . '¢ '� Stxtc C.,dfiafio.SWista on L Noterized Sipnature of License Holder me this day of 20 L- �� DIANE O.ROCU� � t�v co»tssloN 0 rr0099�1 uve of Notary Public a��. , Fgxp1FM:Apd 21,2017 NO*