900 Plaza - 3 Fixtures Unit 123 s CITY OF ATLANTIC BEACH
! 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
0131 �-
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16 -PLBG -238
Job Type: PLUMBING ONLY
Description: 3 FIXTURES UNIT 123
Estimated Value:
Issue Date: 2/1/2016
Expiration Date: 7/30/2016
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: FLORIDA EMPIRE PLUMBING INC
Address: 5358 HIDDENS GARDENS DR QA ELVIS K LUKAJ
Phone: - -
FEES:
Plumbing Fixtures $21.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $80.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES. i
i
Feb 01 2016 09:12AM HP Fax page 1
PL UMBING PERMIT APPLICATION
63 CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
i a
JOB ADDRESS: 900 P AZA DR, ATLANTIC BEACH FL 32233 UNIT J �J PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fount •n Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray i Water Connected Appliances
Lavatory Water Heater
Other Fixtures 2 Water Treating System
RE -P1PE:
TYNE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fount in 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 1 Water Treating System
MISCELLANEOUS
❑ Sewer Replacement Back Flow Preventer c Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Lawn Sprinkler System - Number of Heads ❑ Well * *
** SJRWD Well Completbn Form. Completed form to be submitted to the Building Department for final inspection,*
❑ Other REPLACE TWO SHOWER VALVES, HOOK UP ONE DISHWASHER DRAIN AND WATER LINE
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 1 have rear
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 aJthority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name S A OATS ACQUISITIONS Phone Number 904 -246 -6474
Plumbing Company FLO' 1DA EMPIRE PLUMBING, INC Office Phone 904 465 2538_Fax 904 725 - 2257
Co. Address: 5358 HIDD N GARDENS DR City JACKSONVILLE State Zip 32258
License Holder (Print): lvis Luka: State Certification/Reegistration CFC 1427347 •
Signature of .f 1
Notarized Si L cease Holder 's , , At'
,es,, THERESA Y C SPER Sworn and subscribed before me this 1 day of ) 20
:: MY COMMISSION 11' 915797
;;,,. EXPn:E$ 07, 20s9 Signature of Notary Public