1704 MARITIME OAK DR - PLUMBING '� 1 �S CITY OF ATLANTIC BEACH
e" 8(H) SEMINOLE ROAD
J� 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-681
Job Type: PLUMBING ONLY
Description: 26 fixtures
Estimated Value:
Issue Date: 3/21/2016
Expiration Date: 9/17/2016
PROPERTY ADDRESS:
Address: 1704 MARITIME OAK DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: NELSON PLUMBING CO. INC.
Address: 11624 -1 DAVE 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 $182.00
Total Payments: $241.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TILE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904)247-5845
JOB ADDRESS: 114 q pl A e tT 11'UIe O - DrL PERMIT# ( -Sn2--51/
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OFFA'TURE - QTY TYPE OF FIXTURE Qty
Bathtub ( Septic Tank&Pit
Clothes Washer ( Shower _ 3
Dishwasher ( Shower Pan _
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 4 - 0
Hose Bibs 3 Urinal
Kitchen Sink ___L___ Vacuum Breakers
Laundry Tray __l.___ Water Connected Appliances —T-
�e� �_ Water Heater —T .
—.i_ Water Treating System ____1RE-PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTT,
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Drain Three Slop Sink
Floor Three Compa tmment Sink
Floor Sink Toilet
Hose Bibs Urinal
- Kitchen Sink Vacuum Breakers
Lavatory a Tray Water Connected Appliances
water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
o Sewer Replacement o Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of ph
o Lawn Sprinkler System-Number of Heads _ o 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 specii
or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of constructic
Property Owners Name P-l V E LS i D T I O RI E S Phone Number
Plumbing Company AIacoN Pt00113i46 Co T c. Offs Phone/Off 162. 'f gt( Fax
•Co.Address: 62'4-( A V1
i L / / , u 4 `� (t.SonV� fit) State �C Zip�
License Holder(Print): , MS ./. ' , _1 `L .On/ 1 -rtification/Registration# 02.0 37q
Y tgn i'efre 'Livens t Holder i' '�4II N `
:(* MY COMMISSION t F 900342 , r
,,. ,ro= EXPIRES:November 16,2019 Sworn and sub :�.
Bonded Thru Notary Pubfic Under writers before me this �� �, 20
Air / LIN
Sigture of Notary Public