1776 MARITIME OAK DR PLUMBING PERMIT CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
oil I q
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-1325
Job Type: PLUMBING ONLY
Description: PLUMBING - 30 FIXTURES
Estimated Value:
Issue Date: 6/9/2016
Expiration Date: 12/6/2016
PROPERTY ADDRESS:
Address: 1776 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:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $210.00
Trade Permit Base Fee $55.00
Total Payments: $269.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 16 _ P L()e_ )
JOB ADDRESS: (71(o MAQtT1 MF 01+ DIS PERMIT # 16-SM-Ab-7
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFIXTURE QTY TYPE oFFIXTURE 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
Other Fixtures ^ Water Treating System
RE-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
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ 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 read
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 authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name R-1 VEeS1'OE Lq uNiEf Phone Number
Plumbing Company A197urQ0*V PUaWA-, VG C2 -r;Ve-. Office Phone 2(a L. 422 9 q Fax
Co. Address: 1142+ WI`, OMAk, 2Z Cit nvl State JL_Zip 3LZS�6
License Holder(Print): 0-1V e ification/Registration# 01.0 3-)q
Not ari lder
USA R Bass
MY COMMISSION M FF 9o0342 Before me this _day of 20
=•i';a, : 'i� "
EXPIRES-November
16,2019
3ondedThruWterYPub6eUnder*'ters
—
„, Signature of Notary Public