1 FLEET LANDING - PLUMBING NEW WATER HEATER , CITY OF ATLANTIC BEACH
4 2 800 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-2351
Job Type: PLUMBING ONLY
Description: PLUMBING - NEW WATER HEATER
Estimated Value: $750.00
Issue Date: 10/6/2015
Expiration Date: 4/3/2016
PROPERTY ADDRESS:
Address: 1 FLEET LANDING BLVD
RE Number: 169397-0200
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BOULEVARD
GENERAL CONTRACTOR INFORMATION:
Name: DAVID GRAY PLUMBING INC.
Address: 6491 S POWERS AVE QA DAVID FRED GRAY
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $7.00
Trade Permit Base Fee $55.00
Total Payments: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 15-_ PLP - 735 I
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JOB ADDRESS: I Y�GZ4- ID,'d,,lb &JVd. A4'Ia '1- &Q(t l /32233 PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ 750
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 r
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 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 violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name `(tt �(:)/ -dI/J l�-€T ven'lln-)- LI v rn(- Phone Number(fU-) 7 4v- ' 0 0
Plumbing Company-Da✓t GQ I[,t.1.,.�b)�, ,I a G. Office Phone[ )1L'I'12 7/Fax -356'328/
Co. Address: (o 0 I hD� s City j a 45,0,-10.I le...State hL Zip 3 ZZ1'7
License Holder(Print): V\d State Certification/Registration# CFCO2. 5-fko
, Atte/
older
ow■y Notary Public State of Por.aa�: Wendy Rayle Sworn and subscribed before me this day of 0� 20 6.av. a My Commiss on FF 133678
Expires 06117/2018
Signature of Notary Public -Pi-J- , 416(----