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1960 BEACH AVE - PLUMBING c_j" \s, CITY OF ATLANTIC BEACH .� ` _ ,� 800 SEMINOLE ROAD Jt ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-PLBG-1388 Job Type: PLUMBING ONLY Description: PLUMBING - 9 FIXTURES Estimated Value: Issue Date: 6/16/2016 Expiration Date: 12/13/2016 PROPERTY ADDRESS: Address: 1960 BEACH AVE RE Number: 169525-0050 PROPERTY OWNER: Name: FARRIN, JONATHAN S & ANNA L, * Address: 1960 BEACH AVE GENERAL CONTRACTOR INFORMATION: Name: NELSON PLUMBING CO. INC. Address: 11624 -1 DAV E DAVIS CREEK RD QA SCOTT GARY NELSON Phone: - - FEES: State PLMG DBPR Surcharge $2.00 Plumbing Fixtures $63.00 Trade Permit Base Fee $55.00 State PLMG DCA Surcharge $2.00 Total Payments: $122.00 PERMIT IS APPROVED ONLY IN ACCORDANCE Willi ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 I Ph(904) 247-5826 Fax (904) 247-5845 G - P ' - 1388 JOB ADDRESS: I 'q,0 g E-6-ck Ave- PERMTL i�� .42 NEW O ' REPLACEMENT I STALLATION: Project Value$ 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 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 o Back Flow Preventer 0 Grease Interceptor(Trap)- gallons(Requires 3 sets of plans) 0 Lawn Sprinkler System-Number of Heads 0 Well ** **SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.** in 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 sante 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 Nam- 3(.,nc-,- a c F-cL//��I t : PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904)247-5826 Fax(904) 247-5845 JOB ADDRESS: ) 0 L 0 g t f}-Gt 14UE PERMIT# 16 ^ gA4K(k NEW O REPLACEMENT NSTALLATION: Project Value$ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub _7_ Septic Tank&Pit Clothes Washer Shower t 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 3 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 0 Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans) ❑ Lawn Sprinkler System-Number of Heads 0 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 Nam Phone Number Plumbing Company ELSoov Pt,ton# u1G (20 TA/c__ Office Phone ZI Z. t a9 LI Fax Co. Address: It 6/ ( I)RJt`t C2(. _ F City �.e State k Zip3 .2.S-6 License Holder(Print): C o A S') - , 11 a - Certification/Registration# 02-0 3�)1 •a/jr.. Notarized Signature of License Holder A I /r _ir : USA P..BASS Before me this I day of -ZUY�_ 20 l ce c • MY COMPASSION SSION t FF 900342 ...;...+40 ...41/ EXPIRES:November 16,2019 Signature of Publ' c�— '•..g„:t Bonded Tnru Notary Publie Underwriters Notary