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2349 Seminole Reach Ct - Plumbing - 38 Fixtures r :iil--. v f t ,� v CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD - ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 j ' 4 9iilr-Vs' PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814 JOB INFORMATION: Job ID: 16- PLBG -41 Job Type: PLUMBING ONLY Description: PLUMBING - 38 FIXTURES Estimated Value: Issue Date: 1/7/2016 Expiration Date: 7/5/2016 PROPERTY ADDRESS: Address: 2349 SEMINOLE REACH CT RE Number: None GENERAL CONTRACTOR INFORMATION: Name: NELSON PLUMBING CO. INC Address: 11624 -1 DAV E DAVIS CREEK RD QA SCOTT GARY NELSON Phone: - - FEES: State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Plumbing Fixtures $266.00 Trade Permit Base Fee $55.00 Total Payments: $325.00 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 I 6 -Pc ( C - 4 i JOB ADDRESS: 13 1 q S C to i,Q fe i g E a C . t , &r P E R N I 1 T # / SR-2850 NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub )-• Septic Tank & Pit Clothes Washer O Shower _ Dishwasher . Shower Pan 3 Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet 1 Hose Bibs C Urinal Kitchen Sink Vacuum Breakers Laundry Tray — 1 — Water Connected Appliances Lavatory ___a_____ ater Heater . Other Fixtures at ater Treating System RE -PIPE: ("- j TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower Dishwasher Rower 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 pia ❑ 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 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 specif or not. The permit does not give authority to violate the provisions of any other stare or local law regulation construction or the performance of constructio Property Owners Name /G i ✓>✓ 2s) p, 1/0'4 CS Phone Number Plumbing Company MLS °" PLumA1/0(-) Office Phone %D v. 262 • V38 `(Fax Co. Address: 11 (,2)-i — ( Pelvt5 (t2 Et P • ity 3n-ots ✓liii (Cr State Zip 2?S6 License Holder (Print): :SNIT n, e )0( i' tate Certification/Registration # c� 628379 e Holder j '' _ �; ::y .. USA P. BASS I r � '4; �` f = MY COMMISSION * F F 900342 Sworn and sub cribe• before ine t is 3 day of ) Ct n U.� 2016 _ �' �. EXPIRES: November 16, 2019 CP g R,` R °: �� ' Bonded Tbru Notary Public Underviters Signature of Notary Publi i�.