900 PLAZA #77 - PLUMBING 1 �S f CITY OF ATLANTIC BEACH
_ s-) 800 SEMINOLE ROAD
\ " ATLANTIC BEACH, FL 32233
\ INSPECTION PHONE LINE 247-5814
0
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-2383
Job Type: PLUMBING ONLY
Description: PLUMBING - 8 FIXTURES
Estimated Value: $2,100.00
Issue Date: 10/8/2015
Expiration Date: 4/5/2016 . 77
PROPERTY ADDRESS:
Address: 900 Plaza
RE Number: 171725-0500
PROPERTY OWNER:
Name: SEA OATS ACQUISITIONS. LLC
Address: 645 MAYPORT RD SUITE 5 645 MAYPORT ROAD SUITE 5
GENERAL CONTRACTOR INFORMATION:
Name: MICHAEL G BOWEN PLUMBING, INC
Address: 6840 San Souci RD
Phone: 904-725-0600
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $56.00
Trade Permit Base Fee $55.00
Total Payments: $115.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII 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 t 5 -P L 66-z 33
JOB ADDRESS: ?ipo P!4 Z Q RI 9 7 PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value$02/X °—�
TYPE OF FIXTURE QTY TYPE OF FIXTURE Q7'Y
Bathtub I Septic Tank&Pit
Clothes Washer ( Shower l
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet �_.
Hose Bibs Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory __ Water Heater
Other Fixtures Ce.2 Water Treating System
RE-PIPE:
TYPE OF FIXTURE Q7'1' 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 o Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
**SIRWD 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 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 'olate the provisio I s of any other state or local law regulation construction or the performance of construction.
Property Owners Name - Of,'I ' I ^ 6 Phone Number
Plumbing Company f)'1i'e_4'ssf i /lt/,,,„ Office Phonef * 7 LS-0 i e
Co. Address: Sikk 14 C. C.' ' City 3-"4-4 State r Zip 3ZZI4
License Holder(Print):flu;Cl QQit 4 Au) y� /j State Certification/Registration#(1 Fee 5'??3 2-
Notarized Signature of License Holder /X ugj L 7V9
Before me this day of DC fo b P C 20 15
44.,.. Nancy Notary PublicE Bail Stat
et
e of Florida
h1y Commission EE 156116 Signature of Notary Public
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'orn�� Expires 02/08/2016