1031 OCEAN BLVD - PLUMBING ,, f- JVD
' CITY OF ATLANTIC BEACH
J \�1
t "'```I \Sy 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
9INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-1412
Job Type: PLUMBING ONLY
Description: PLUMBING - WATER HEATER
Estimated Value: $270.00
Issue Date: 6/20/2016
Expiration Date: 12/17/2016
PROPERTY ADDRESS:
Address: 1031 OCEAN BLVD
RE Number: 170253-1000
PROPERTY OWNER:
Name: BOSTWICK JR, WILLIAM COWAN VAL
Address: 1031 OCEAN BLVD
GENERAL CONTRACTOR INFORMATION:
Name: A J MOREL PLUMBING INC
Address: 8915 CASTLE ROCK DR ARTHUR JAMES MOREL
Phone: - -
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: $66.00
1
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
B(IIA)ING CODES.
a
06/20/2016 10: 16 9043745198 AJ MOREL PLUMBING PAGE 02/02
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 1 CD_ P L e,G / 4
JOB ADDRESS: 1031 ()czar) 8/v'd. A /an h G ,each Ft 02233 PERrr#
NEW OR REPLACEMENT INSTALLATION: Project.Value$ d2.-1 D ,ov
TYPE OF FIXTURE QTY TYPE OF FIXTURE QrE
Bathtub Septic Tank&Pit
Clothes Washer Shover
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 Q rr
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 ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Lawn Sprinkler Systerrm-Number of Heads ❑ Well **
**.SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.*
Other epIaC i eiF or elec= lG wa ° -ht1 .
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 Ihave 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 VLt 113 QSi-Gul Gk- Phone Number 904-.3 q3-4s5-1..
Plumbing
i3-45.5 -
Plumbing Company A .J, Morel. P1IAmh n), . inc, Office Phone gotl- V 6-0797 Fax 9oy-374-51ge
Co. Address: 8q6 Cosi-le 1tc i D city Jackso11V71Ik. State F->'- Zip 32211_
..__
License Holder(Print): A ri-h U r . )`i) 0 ' . I tate Certification/Registration# Ccr /4,77-47ZO .,
Notarized Signature of License Holder 7 ,
r�'`""`4� SUSAN P. CARLI LE Sworn and subscribed before me s QX) da of u , 20 l
t�'..,
rr. , MY COMMISSION#FF064428
zy(ci'ti EXPIRES January 20,2018 Signature of Notary Public c
(40.4'316_01W FlorfdallotaryService.com