4000 FLEET LANDING #4313 - PLUMBING ,S r Jai
"' vs, CITY OF ATLANTIC BEACH
,,,.;:� 800 SEMINOLE ROAD si
/ -" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
' o_),V
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-486
Job Type: PLUMBING ONLY
Description: 2 FIXTURES UNIT 4303
Estimated Value:
Issue Date: 2/26/2016
Expiration Date: 8/24/2016
PROPERTY ADDRESS:
Address: 4000 FLEET LANDING BLVD
RE Number: LOC ID-0000 4-3 ( 3
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BLVD
GENERAL CONTRACTOR INFORMATION:
Name: ASHLEY PLUMBING CO INC
Address: 542435 US Hwy 1
Phone: - -
FEES:
Trade Permit Base Fee $55.00
State PLMG DCA Surcharge $2.00
State PLMG DBPR Surcharge $2.00
Plumbing Fixtures $14.00
Total Payments: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
FEB-26-2016 06:09 From: To: 19042475845 Page:2.7
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 �,� j}_ y�
Ph (904) 247-5826 Fax (904) 247-5845 1 i?J lf�
JOB ADDRESS: t 3) "a-- ( .i t IA!: PERMIT#
VEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXtuRE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan cg
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
2E-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
Lavatory Water Heater
IOther Fixtures Water Treating System
1IiSC E LLANEOUS:
Sewer Replacement ❑ Back Flow Preventer D Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
Lawn Sprinkler System-Number of Heads D Well **
'* SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
7. Other
ermit 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
tis application and know the same to be true and correct. All provisions of laws and ordinances governing this work will he complied with whether specified
r not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
'roperty Owners Name FIB el- Lard i Phone Number q0 Li`aWWO-MO
'lumbing Company t l5V1Icki 0"t„m6 r , 1 Fn 'Inc . Office Phone VI-393- % Fax'7 -0SS2.
;o. Address: SLip2LG5 0 HitiLf 1 J City CCOlGL n State `Ft- Zip 3 O i l
icense Holder(Print): 01 if'i5-btoher 4)I ` 7 . State Certification/Registration# 057,0 Lf
iotari ed Si nature o License Holder ei._....., t
„may. �,4 day . thil,U_QA,1, 20 6
r,�•�� �, KELSEY R STROBL'1� �,m and subscribed before m this �q da of
1‘*,, ! MY COMMISSION#FFI 72428 / /�
,?n.n , EXPIRES October 28,2010 •nature of Notary Public p, , „.4_6 0
Notary
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