4000 FLEET LANDING #4101 - PLUMBING CITY OF ATLANTIC BEACH
s J 800 SEMINOLE ROAD
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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-1959
Job Type: PLUMBING ONLY
Description: UNIT 4101 - PLUMBING - 2 FIXTURES
Estimated Value:
Issue Date: 8/29/2016
Expiration Date_ 2/25/2017 - — —
PROPERTY ADDRESS:
Address: 4000 FLEET LANDING BLVD
RE Number: LOC ID-0000
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BLVD
GENERAL CONTRACTOR INFORMATION:
Name: ASHLEY PLUMBING CO INC
, CFC057804
Address: 542435 US Hwy 1
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $14.00
Trade Permit Base Fee $55.00
Total Payments: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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AUG-26-2016 23: 17 From: To:9042475845 Pase:6'6
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
ei_ ''DQO 800 Seminole Rd Atlantic Beach, FL 32233
t Ph(904)247-5826 Fax (904) 247-5845
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JOB ADDRESS: (-PO i Red-/a id/ PER #
NEW OR REPLACEMENT INSTALLATION: Project Value$
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
R.E-PIPE: 0
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 BibsUrinal
Kitchen SinkVacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other FixturesWater Treating System
Vi1SCELLANEOUS:
Sewer Replacement o Back Flow Preventer D Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
7 Lawn Sprinkler System-Number of Heads 0 Well ** �*
'* SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection_
3 Other
'crmit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.1 hereby certify that I have read
his application and know the same to be truc and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
111-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.
'roperty Owners Name Fleet Landing,_ Phone Number 904-246-9900
'lumbing Company ASHLEYPLUMBINO COMPANY INC. Office Phone 904-393-7959 Fax904-399-0552
:o. Address: 542435 US Hwy 1 City Callahan _ State FL Zip 32011
License Holder(Print): CHRISTOPHER S..AS$EY State Certification/Registration#CFC057804_
Notarized Signature of License Holder_ -.�,�;..,.,
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Sworn sL$set'iljed before • : of id,'4' 20hO_
xli ,' Nathan P. 7Ldter : -�' glir—
f4rpGjg2o10�CamrssranFF152435 Signaof 1stary. uc / -/
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