331 SKATE RD - PLUMBING C ---
-\1`1-1; ;S 1, CITY OF ATLANTIC BEACH
_ 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: 16-PLBG-57
Job Type: PLUMBING ONLY
Description: WATER HEATER
Estimated Value:
Issue Date: 1/8/2016
Expiration Date: 7/6/2016
PROPERTY ADDRESS:
Address: 331 SKATE RD
RE Number: 171677-0000
PROPERTY OWNER:
Name: REVERSE MORTGAGE SOLUTIONS,INC
Address: 2727 SPRING CREEK DR
GENERAL CONTRACTOR INFORMATION:
Name: SUPERIOR CONTRACTORS LLC
Address: 4040 SUNBEAM RD QA EDWARD WINTERS, JR
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: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEA( II ORDINANCES AND THE FLORIDA
BUILDING CODES.
i.'S yV.t f',r
,mss '�� , ATLANTIC BEACH
7_ vN
PERMIT RECEIPT
,,$)%
PERMIT DESCRIPTION: WATER HEATER
PERMIT NUMBER: 16-PLBG-57
ADDRESS: 331 SKATE RD
OWNER: REVERSE MORTGAGE SOLUTIONS,INC
DATE ISSUED:
FEES DUE:
State PLMG DBPR Surcharge $0.00
State PLMG DCA Surcharge $0.00
Plumbing Fixtures $0.00
Trade Permit Base Fee $0.00
RE-INSPECTION FEE $55.00
Totals:
5.00 , IP
WILD/41
S \.y; O
T.-,10 -
NOTICE
OF
Fp ADDITIONS t)'' or CORRECTIONS
qKM DO NOT REMOVE
JOB ADDRESS DATE
3) ( )«)s:r'2 (-� t 2_r< i 1 L1
THIS JOB HAS NOT BEEN COMPLETED
The following additions or corrections shall be made
before the job will be accepted.
P �....)rA V..,A «i C- c7:7( sL. 1..(0 -r- -- .k-1-:)
'et) $ T- 1,1.1—fg—e4 i t`1 %.--) "i'..4.....e-- .fd
N1t C-4 FTs.1 •k L.. ) IBC..
l *
'►-1 K C CI. a1. .-r
1
11
11
c..1155.00 REINSPECT FEE 7 NO CHARGE
Its is unlawful for any Carpenter, Contractor, Builer or other
persons, to cover to cause to be covered, any part of the
work with flooring, lath, earth or other material, until the
proper inspector has had ample time to approve the
installation.
After additions or corrections have BLDG
been made contact the Building Dept. ELEC
at 247-5814 for an inspection. Office MECH C-----
hours are Monday through Friday PLMG `'-
8:00 a.m.to 5:00 p.m.
L. ƒ 0 ƒ / C O / / /
) \ \ ° R \ ] o § d \ 2
& % -1 O_ E 3o ° ° 0
2 \ q -1 Ws:
/ � / - 0
- Q =
\ 3 ) \ k / \ —I
ƒ •$ CO § o § o \ / %
o•Q _ o 9. q &
/ - § f g .. ƒ
/ = D 2
o
co \ z [\ / \
o e m 9 / / z \ '® ° CO
\ °CT) CD / % / ƒ c @ �? / i
& o w z 2 o- a ' m % &
2 C-1,) -1 § s
R / / / / 73 m co
m
2 \ -I 0 \ \
c \o z / 2
k m m >
0 9 \
G 0
/ 1 3 73 E W
a k
/ 0
2
i z G
n 0
0 0
3 %\\
3 74
\� 0
\ 0 o 17
_ .». ) §
\ °_ ` ƒ 0
cn
k / D cn
3 n o
o
/ /
0 0
CO °
a Z
O
/ 7 s
ND S §
/ )
o \
7 n
e 01
\
Cl) \
a >
.
(7).
&
3
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904)247-5845
JOB ADDRESS:, 4"\t x l PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ -moo.c
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
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 1 a.`
Lavatory Water Heater ti/
Other Fixtures Water Treating System e lG
MISCELLANEOUS:
❑ Sewer Replacement ❑ 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.**
❑ 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 auttIl wity t violate th• provisions of any of er state or local law re lation construction or the performance of construction.
Property Owners Name `V v tY t•• • °` I� lelc N. , , U.-Pho e Number
t p
Plumbing Company�� ` l �G{ /� Office Phone
� , IS 1 Fax
Co. Address:q� ,11t� . ' City ti/ lIysl(a State Zip&27 1 �
License Holder(Print): �, State Certification/Registration # 0:4-'02-.4C--- -\-"C
Notarized Signature of License Holder ! / 11
1 ""'y Kiln."ASHBAUGH Sworn an: subscribed before this " _ d f�J-A-N`^r'r� 20 H p
1 '` . Notary Public-State of Honda ,r e
•3 Commission•f FF 23006! Signature of Notary Public nig,X-. [, My Comm. u Assn g Y �/
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
PHONE (904) 247-5855
Cashier Id: aspcust\atlbbja
Receipt Date: 1/8/2016 9:53:55 AM
Receipt Number: OS-68943
Job ID: 16-PLBG-57 - WATER HEATER PDBPR -
State PLMG DBPR Surcharge $2.00
. Job ID: 16-PLBG-57 - WATER HEATER PDCA - S
tate PLMG DCA Surcharge $2.00
Job ID: 16-PLBG-57 - WATER HEATER PL1 - P1
umbing Fixtures $7.00
Job ID: 16-PLBG-57 - WATER HEATER TP - Tra
de Permit Base Fee $55.00
Amount Due: $66.00
Tender Information: Cash $66.00
Tender Type: CC
Tender Amount: $66.00
Change Due: $0.00