1770 Maritime Oak Dr - Plumbing 22 Fixtures ,,„1_,..tv,,
v.,,i4iik �s' CITY OF ATLANTIC BEACH
r 9 800 SEMINOLE ROAD
+ 4� }fin j /
vj u ATLANTIC BEACH, FL 32233
� INSPECTION PHONE LINE 247 -5814
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PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16 -PLBG -370
Job Type: PLUMBING ONLY
Description: 22 FIXTURES
Estimated Value:
Issue Date: 2/16/2016
Expiration Date: 8/14/2016
PROPERTY ADDRESS:
Address: 1770 MARITIME OAK DR
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:
Trade Permit Base Fee $55.00
State PLMG DCA Surcharge $2.00
State PLMG DBPR Surcharge $2.00
Plumbing Fixtures $154.00
Total Payments: $213.00
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
JOB ADDRESS: V1 1 0 n A Q. i T i ry1E Oft. k- D (L L it to PERmn # 16 -Sc{Z_- lad
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 2- Septic Tank & Pit
Clothes Washer _]_ Shower t
Dishwasher __L_ Shower Pan _1_
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Z Urinal
Kitchen Sink __J_ Vacuum Breakers
Laundry Tray Water Connected Appliances 1
Lavatory S Water Heater 1
Other Fixtures 1 Water Treating System t
RE -PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
CIothes 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
MISCELLANEOUS:
o Sewer Replacement 0 Back Flow Preventer o Grease Interceptor (Trap) gallons (Requires 3 sets of pia
o Lawn Sprinkler System - Number of Heads 0 Well - **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection
D 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 pro - - ons of any other state or local law regulation construction or the performance of constructio
E Property Owners Name IL 1 ye -s I o c V m E S Phone Number
—
Plumbing Company !/E I-S ory PLi4w, a I /'V 6 Co �NC . Office Phone 9D (( 2U2 • `I 13 Fax
((6 - ( D11kii C I,c_ Ci , , At'�tr Ii ll € S tate f t zip 2ZSi
Co. Address: � p � ' P
License Holder (Print): $Cc9 IT I V EC--S GA./ I i i i t . - t -rtification/Registration # �1.O319
-.:,.; ri - - - ;f— o ` wTJ e Holder ir
... ° = MY COMMISSION t FF 900342
y'. ' EXPIRES. November 16, 2019 Sworn and subscrib d lb efore /tie thi I day o - 2 j
'• % ►gi p CV Bonded Thru Notary Public Linden/titers
S ignature of Notary Public 6 G P • 011/