The URL can be used to link to this page

1031 OCEAN BLVD PLBG PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD -� ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 30B INFORMATION: Job ID: 16-PLBG-1430 Job Type: PLUMBING ONLY Description: PLUMBING - REPLACE WATER SOFTENER Estimated Value: Issue Date: 6/23/2016 Expiration Date: 1212012016 PROPERTY ADDRESS: Address: 1031 OCEAN BLVD RE Number: 170253-1000 PROPERTY OWNER: Name: BOSTWICK JR, WILLIAM COWAN VAL Address: 1031 OCEAN BLVD GENE RAL CONTRACTOR INFORMATION: Name: HYDRO MEDIX TECHNOLOGIES INC Address: 10940 US HYW 1 N Suite SUITE Phone: 904-230-6393 FEES: State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Plumbing Fixtures $7.00 Trade Permit Base Fee $55.00 Total Payments: $66.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATL IC 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: IO ( I//�C PG1 P, RIA PERMIT# NEW O REPLACEMEN INSTALLATION: Project Values TYPEOFFIXTURE 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 Treatii�lg System RE-PIPE: TYPEoFFIxTURE QTY TYPE oFF/XTURE 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 +' ++SIRWD 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 conal. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authoritytoviolate the provisions of any other score or local law regulation consWction or the performance of construction. Property Owners Name V(A DQS�L� kd e, Phone Number _Company II'' c Office Phone qi3 Fax -�/`aLr 14.3 Co. Address: 1VgR0 U 4WV 1 li, 5 -fie t3 City Y StateF� Zip License Holder(Print). L �l tion/Registration# Notarized Signature ofLicense Holder tenor&vntuuas Sworn d s scribed be ore me s ,]_day of U20 (C � -. arcoMuasaonavFsn+u .Grp Sigtature Of Notary Public 2015-2016 BUSINESS TAX RECEIPT All MICHAEL CORRIGAN,DUVAL COUNTY TAX COLLECTOR - 231 E FORST STREET,SUITE130.JACKSONVILLE.FL 32202-3370 Prone:(904)830.1918,amain 3; Fax (904)63NI432 Masks:wxa.,mads q Email:taxwlledor®Coj.rot Note—A penalty is imposed for failure to keep this receipt exhibited conspicuously at your place of business. This business tax receipt is furnished pursuant to Municipal Ordinance Code,Chapters 770-772,for the period October 1, 2015 through September 30,2018, LOSCHIAVO,JOSEPH J HYDRO MEDIX 734 OTTER CT JACKSONVILLE, FL 32259 II ACCOUNT NUMBER: 22021 LOCATION ADDRESS: 734 OTTER CT JACKSONVILLE, FL32259 DESCRIPTION: QUALIFYING AGENT,CONTRACTORS COUNTY RECEIPT DESC: QUALIFYING AGENT,CONTRACTORS COUNTY TAX: 0.00 MUNICIPAL RECEIPT DESC: MC 772.325 MUNICIPALTAX: 100.00 TOTAL TAX PAID: 100.00 VALID UNTIL September 30,2016 ***ATTENTION*** THIS RECEIPT IS FOR BUSINESS TAX RECEIPT ONLY. CERTAIN BUSINESSES MAY REQUIRE ADDITIONAL STATE LICENSING. This is a business tax receipt only. It tices not permit the receipt holder to violate any existing regulatory or zoning laws of the County or City. It does not exempt the receipt holder from any other license or permit required by law. This is not a cerlifcation of the receipt holder's qualifications.. TAX COLLECTOR THIS BECOMES A RECEIPT AFTER VALIDATION. PAID-4057162 . 0002-0002 Y01 10/01 /2015 100. 00