1753 MARITIME OAK DR - PLUMBING - CITY OF ATLANTIC BEACH
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800 SEMINOLE ROAD
� ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
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PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
708 INFORMATION:
Job ID: 15-PLBG-1940
Job Type: PLUMBING ONLY
Description: PLUMBING - 25 FIXTURES
Estimated Value:
Issue Date: 8/14/2015
Expiration Date: _ 2/10/2016 _
PROPERTY ADDRESS:
Address: 1753 MARITIME OAK DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: DON HARRIS PLUMBING GO..ING.
Address: PO BOX 14668 QA NELSON D. HARRIS
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: $234 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH 15- P L B G- tc1040
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 165 1.52460
JOB ADDRESS: / 5.9 /t- / KP ��j A - PERMIT# ` K
NEW OR REPLACEMENT INSTALLATION: Project Value$ (Dl I be)
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub . Septic Tank& Pit
Clothes Washer Shower ____�ufSj4Q.
Dishwasher Shower Pan _L.__Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink U! Toilet i•
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Connected Appliances
Lavatory (o Water Heater i
Other Fixtures 2 I3R SINK 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:
D Sewer Replacement L] Back Flow Preventer a 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 read
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 violat the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Namef hone Number
Plumbing Com y
Don Hams Plumbing Co., Inc. Office Rio-772-0`7 CZ) Fax 7 79'258Q
Co. Address: 2 lt�. � i3 I Jfi City a! State 't(.Zip 3220
License Holder(Print): //EL SOW _b• /1-1--The_ki5 State Certification/Registration# CF- DI engq
Notarized Signature of License Holder J __.-----�%
:*i+:141 KIM BUTLER
;t� ' Sworn and subscribed before me is day of ��k%1�� 20�
_.. "Is :.= Commission#FF 030749 ///
—;,;=.7.4.,.:# Expires October 25,2017 /
ARf.V Bonded Tin Troy Fain lnmrwrc*800-385.7019 Signature of Notary Public .,- r I I*
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