75 10TH ST - PLUMBING -jVi.'
4
� �� CITY OF ATLANTIC BEACH
s� 800 SEMINOLE ROAD
JV - 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-1553
Job Type: PLUMBING ONLY
Description: Plumbing - replace bathtub, one fixture
Estimated Value: $2,000.00
Issue Date: 7/11/2016
Expiration Date: 1/7/2017
PROPERTY ADDRESS:
Address: 75 10TH ST
RE Number: 170263-0030
PROPERTY OWNER:
Name: MARK, FORREST H
Address: 2833 SINKS CANYON RD
GENERAL CONTRACTOR INFORMATION:
Name: ATLANTIC COAST PLUMBING CORP.
Address: 3653 REGENT BLVD APT 305 QA NICHOLAS ARLON
PARRISH
Phone: 904-997-3278
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
111
/11
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
' , ATLANTIC BEACH
SS1`
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: ' PERMIT RECEIPT
PERMIT DESCRIPTION: Plumbing- replace bathtub, one fixture
PERMIT NUMBER: 16-PLBG-1553 P `O
ADDRESS: 75 10TH ST 11%%la
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OWNER: �v I�PN�\G p.G
�OP ,
DATE ISSUED: G��f,�j�,��
FEES DUE:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $7.00 CITY Of ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
4 Trade Permit Base Fee $55.00 07.112016 14:32:48
CREDIT CARD
VISA SALE
Totals: CARD„ XXXXXXXXXXXX5358
j $66.00 INVOICE 0002
SEQ 0002
Batch s; 000354
Approval Code: 033251
Entry Method: Manual
Mode: Online
0 Tax Arnoint: x0.00
Card Code: M
SALE AMOUNT 566,00
CUSTOMER COPY
II0
07%11-2016 09:57 FAX 9046459363 atlantic-coast 001
0E-06-15; i0; 14 ;From: To:96459363 ;9042475845 # 1/ 1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904)247-5845 ( ( - 3t f _ i E S3
JOB ADDRESS: .75' /d 7 ,7Tr _? PERiv7RT#
NEW 0• REPLACEIVIEN INSTALLATION: Project Value$ a& ••c""
' ' of &TU.It QTY TYPE OF FIXTURE' Qrx
Bathtub / Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
. Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Prose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavator' Water Heater
Other Fixtures Water Treating System
RE-PLPE:
TYPE OF PATORE QTY TYPE OF FIXTURE, QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher _. Shower Fan
Drinking Fountain Slop Sink
Floor Three Compartment Sink
Floor Sink — Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Heater `
Other Plxtures Water Treating System
fLSCELLANEOUS:
ewer Replacement 0 Back Flow Preventer ❑ 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 tMituilding Department for final inspection.**
Other
..w..,a.....
mit becomes void;Iwo*does not commence within a six month period or work Is suspended or abandoned for six months.I hereby certify that I bora read
a eppiicetlon and keow the Same to be true and correct All provisions of taws and ordinances i{oveminq this work will be complied with whether spochicd
lot. The permit does not give authocly to violate the p visions of any other state or local law regulation construction or the performance of oonatrnotien,
)perty Owners Name,,. �47 r in r9 Phone Number 500?-5 o 6 .
lmbing Company ..i s4/4tr , ' C'7,-,,./a'5 74 Pi6m 6 I (-Al",Office Phone jf 73.g7 Flue .0 Y51-f 3 65. Address: 36 5-' . , • ,i/Lizi ' 5o5' /-''./0zip 3. it
tense folder (Print): ,•c-Ao X45 1. fii-/-/.. / i cats nfl.e stration# ('t Go Lo
rarized Signature of License Holder , GG' -k'
,_____ AY LINDSSf3ELMONT
• , COMMISSION BE# sassoz Before me this /1 day of Jv/ 20_/ '.
WIRES:JAN 12,2O20 Si azure of NotaryPublic • '
•a- Bonded through t et State Insurance $ll .,y,�,.,;.J;,� (�
r?.-L`!rl�,r` Permit Inspections
40
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City of Atlantic Beach
Permit Number: 16-PLBG-1553 Description: Plumbing-replace bathtub,one fixture
Applied: 9/25/2019 Approved:9/25/2019 Site Address: 75 10TH ST
Issued:9/25/2019 Finaled:9/26/2019 City,State Zip Code:ATLANTIC BEACH, FL 32233
Status: FINALED Applicant: <NONE>
Parent Permit: Owner:<NONE>
Parent Project: Contractor:ATLANTIC COAST PLUMBING CORP.
Details:
LIST OF INSPECTIONS
SEQ SCHEDULED DATE COMPLETED DATE TYPE INSPECTOR RESULT REMARKS
ID
9/26/2019 9/26/2019 PLUMBING Mike Jones PASSED
FINAL**
Notes: I
Realtor/John:241-3141
Lockbox:1729
Inspected by Universal:Eric Pardee
Printed: Friday, 27 September, 2019 1 of 1 j.