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1733 PARK TER E PLUMBING r- 77�, '' CITY OF ATLANTIC BEACH t _ 1S� .: �, ,) 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 �J;>lc--)`" PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-PLBG-504 Job Type: PLUMBING ONLY Description: 13 FIXTURES Estimated Value: Issue Date: 3/1/2016 Expiration Date: 8/28/2016 PROPERTY ADDRESS: Address: 1733 E PARK TER RE Number: 172020-0406 PROPERTY OWNER: Name: COONAN TRUST, JOHN J Address: 1733 PARK TER 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 $91.00 Total Payments: $150.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 , Ph(904) 247-5826 Fax(904)247-5845 JOB ADDRESS: 1 fl 33 PC l \t Te i i Cl C - J- PERMTr# I _ g!:I1e NEW OR REPLACEMENT INSTALLATION: Project Value$ _ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub I Septic Tank&Pit Clothes Washer Shower _ Dishwasher I Shower Pan ___I____ Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink _ Toilet 3 Hose Bibs • Urinal Kitchen Sink I Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System RE-PIPE: 13 TYPE OF F.ATURE QTY TYPE OF FIXTURE Q 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 Other Fixtures Water Treating System MISCELLANEOUS: Sewer Replacement 0 Back Flow Preventer o Grease Interceptor(Trap) gallons(Requires 3 sets of pia Lawn Sprinkler System-Number of Heads_ O 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 coiiect. All provisions of laws and ordinances governing this work will be complied with whether specif or not. The permit does not give autho i to violate the ovisions of any other state or local law regulation construction or the performance of constructio Property Owners Name + l l r e 0 ,6 m Ne6 l l Phone Number Plumbing Company {),‘50r) 1 mrJ k rt Cu l nC- Offi•- Phone $9 a Fax 6 2,3 Co.Address: I t.L ac-k-I t U t S Ct to k- • q ity/A • Stated Zip to License Holder(Print): . l CG IT SD API: ' . : Certification/Registration# are t)23 7 t . -- .---_ .,,,� teens='Solder ��Iss.so ,. .,4; y;.. Tr- - , Tv 'F'' 4!'•'• MY COMMISSION$FF900342 day of r WYt< ��p ! Sworn and subs' bed before me is •• EXPIRES'November 16 ' Ay• 80+_4 Thru Notary Put*Un,,enordm _ fir - Signature of Notary Public �' i