528 Royal Palms Dr - Plumbing - 1 Shower Pan _: \s CITY OF ATLANTIC BEACH
__ s� 800 SEMINOLE ROAD
J v`� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
MIEN"'"
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- PLBG -1
Job Type: PLUMBING ONLY
Description: PLUMBING - ONE SHOWER PAN
Estimated Value:
Issue Date: 1/4/2016
Expiration Date: 7/2/2016
PROPERTY ADDRESS:
Address: 528 ROYAL PALMS DR
RE Number: 171515 -0000
PROPERTY OWNER:
Name: OGIN JR, EVAN F
Address: 528 ROYAL PALMS DR
GENERAL CONTRACTOR INFORMATION:
Name: ATLANTIC COAST PLUMBING CORP.
Address: 3653 REGENT BLVD APT 305 QA NICHOLAS ARLON
PARRISH
Phone: 904 - 997 -3278
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.
01/04/2016 10:09 FAX 9046459363 atlantic -coast Z001
PLUMBING PERMIT AP i ICATION
CITY OF ATLANTIC 1 EACH
6 SOO Seminole Rd Atlantic Beac JFT.. 32.233 i
�.�'' Ph (904) 247 826 Fax (904) i 7 5545 - L � --
JOB ADDRESS: 2- ` ° Yk C G' dam i PERMIT 0
NEW OR REPLACEMENT INSTALLATION: Project 1 ue S
Tire ur FIXTURE g>rr 77rrs 1 PUMPS gry
Bathtub Septic & Pit
Clothes Washer ""'..`
Dishwuher ir—
Drinking Fountain Shp - . N k —
Floor Drain Throe w• partment Sink _
Floor Sink Toilet
Hose Bibs Urinal _ '^
Kitchen Sink Vacu , Breakers
Laundry Tray Water :4 • - -, Appliances _
L avatory ...,.,.,,.,� Water e e a tar _.._.,—
Other Fixtures Water ing System ____
REE PIPE:
I'm or Ft/MIRE en TYPE • run= err
Bathtub Septic & Pit
Clothes Washer — Sho 4. 1 --
Dishwasher Sho —___
Drinking Fountain Slop S k
Floor Drain Throe • partment Sink _
Floor Sink " Toilet _
Hose Bibs Urinal _____
Kitchen Sink V— BVcalms —
Laundty Tray Water ' A f nneeted Appliances
Levan: Water ; -
Other Fames Water " -..i. g System "-- =
MISCELLANEOUS:
CI Sewer Replacement D Back Flow Preventer 0 Grease ' • r (Trap) gallons (Requires 3 acts of phial')
❑ Lawn Sprinkler System-Number of Heads ❑ W -•' i lb*
" SJRWD Well Completion Form. Completedm to be submitted , he Building Department for Mal inspection_+*
❑ Other _ -
Permit becomes void If work does not commence within a six month period or work is :u., - -. or *bendothed for six months. 1 hereby certify that I have read
this application and know tke sense to be true and correct. All provisions almanac' ... Roverning this work will be oemptled with whether specified
or not The permit does not giva outhotiry to violate ) ° j darts of e other state er local w regatation construction orthe pe-fbvmancc of construction.
Property Owners Nun u 0 re 1 " e �Y
/ -_ Phone Number — 4/‘ 6 ?
PIu nbin Compan Ar4- A-f, r l C d t P (-(�l.µt{ !` 1 I tee Php ue q° `� — ?Jr/4; `{ ? 6.3
Co. Address: 3 { <t: v T GU ti 4.J05 ' j 4_' stela zip `'.2-156
License Holder (Print): .4 ( t
5 t, � ,, . C - . � o # ' f '4J- Q 9�
Notarized Signature of License Holder AZ `' _
• . , .re me this ,clay of L 11 ' 1. �,n 15
, n DIANE O. RUC1lEQ :�. of1<fotory Public ► •
COMMISSION A PPrlpngr '
,,' : EXP IRES
„ April 21. 2v17
CITY OBATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC, FL 32233
01/04/2016 11:39:28
CREDIT CARD
VISA SALE
Card # XXX OOGXXX)O X5358
SEQ #: 4
Batch #: 40
INVOICE 4
Approval Code: 003930
Entry Method: Manual
Mode: Online
Tax Amount: $0.00
Card Code: M
SALE AMOUNT $6600
CUSTOMER COPY