1668 SEA OATS DR - PLUMBING cr\J\
r.. \S CITY OF ATLANTIC BEACH
:. .;;v 5.) 800 SEMINOLE ROAD
"r 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-2674
Job Type: PLUMBING ONLY
Description: 16 FIXTURES
Estimated Value:
Issue Date: 11/13/2015
Expiration Date: 5/11/2016
PROPERTY ADDRESS:
Address: 1668 SEA OATS DR
RE Number: 172020-0224
PROPERTY OWNER:
Name: CROWDER, THOMAS E
Address: 1668 SEA OATS DR
GENERAL CONTRACTOR INFORMATION:
Name: ATLANTIC COAST PLUMBING CORP.
Address: 3653 REGENT BLVD APT 305 QA NICHOLAS ARLON
PARRISH
Phone: 904-997-3278
FEES:
Trade Permit Base Fee $55.00
Plumbing Fixtures $112.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Total Payments: $171.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
11/13/2015 09:38 FAX 9046459363 atlantic-coast RI 001
PLUMBING PERMIT APPLICATION
Cfl Y OF ATLANTIC BLAQ r
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5E26 "L Fax(904)247.5845
Jos ADDRESSZ : _ ,�e� .s:7�T S Dr Parr#
NEW OR REPLACEMENT INSTALLATION: Project Value$ .
TYPE OF FIXTURE' err TrrE cur F trdiE err
Bathtub Septic Tank&Pit
Clothes Washer Shower "'"'
Dishwasher Shower Pan
Drinking Fountain Slop Sink —"
Floor Drain Tree Compartment Sink ��'
Floor Sink Toilet
Hose Bibs �...._ Urinal "�
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Water Heater
Other F Water Treating System
PIPE:
rYPB of FIXTURE QTY T pPE OF FIxNlRE rev
Bathtub / Septic Tank&Pit
Clothes Washer Shower —
Dishwasher —_4___ Shower Fan
Drinking Fountain Si Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs
Kitchen Sink — Urinal
Laundry Tray ' 1 Vacuum Breakers
tY Y Water Connected Appliances
Lavatory _ _ WT _—
Other Fwres et Treating System
MISCELLANEOUS:
❑Sewer Replacement ❑Back Flow Preventer o Grease Interceptor('Imp) gallons(Requires 3 sets of plows)
❑ Lawn Sprinkler system-Numbs of pleads a Well *
**S1RWD Well Completion For►».Completed tam to be submitted to the building Department for final inspection.**
❑nth Pernik becomes void if work does not cornetts c within a six month
p� ae��ix suspended or abandoned for six months.!I►otcby ceet�ry that I have road
this OffliCeddit WI know the lend to be snot and coml. Ail provisions of!sass and ordlannoes Sovernina this work will be complied with whether specified
or not. The meek does not give author/1y te violate the previsions of any other state or Coal law regulation coraareocion or the pefermanee of eenstruetion.
Property Owners Name o 177/9 < o tt./ r Phone Number cO. 8
Phembing Company.gr1/4/Y14i'4- et.}: 5 r /Tin A), Office Phone 9 7-J' 7_Fax ' „ 1r,34,
Co.Address: a _. 4 . f. City i . State P,Zip Z
,.�^ istra�� # �J 4✓/
License Holder(Print): I �.t/r q' /P l” J «ate` ,-:. CC1'tifl r: .on/Registration# (".�` C.-.d�p C O
I Notarised Signature of License Holder VA ikrt.,....it
Before ma this /3 day of o ._.�.. 0 �
0 �`t', DIANE O.ROCLIP
+ MY COMMISSION 0 x00495% Signature of Notmry Public
.44,041;',
oe o5'.$ EXTIRF$';April 21,2017
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