566 Plaza plbg permit .i iy1,`Jij S
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
JOB INFORMATION:
Job ID: 16-PLBG-2164
Job Type: PLUMBING ONLY
Description: PLUMBING - 2 FIXTURES
Estimated Value:
Issue Date: 9/27/2016
Expiration Date: 3/26/2017
PROPERTY ADDRESS:
Address: 566 Plaza
RE Number: 170703-0208
PROPERTY OWNER:
Name: HEINE,JOHN N & NISSE GOLDBERG, '
Address: 566 PLAZA
GENERAL CONTRACTOR INFORMATION:
Name: ATLANTIC COAST PLUMBING CORP.
,CFC050590
Address: 3653 REGENT BLVD APT 305 CIA NICHOLAS ARLON
PARRISH
Phone:904-997-3278
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: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WrrH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
05-06-16; 10: 14 ;From: To:96459363 ;9042475845 # 1/ 1
PLUMBING PERMIT APPLICATION �•4741' 11
CITY OF ATLANTIC BEACH .i,iohn Stoh �ICOR�,u.S.
800 Seminole 1'td Atlantic Beach,FL 32233
// Ph(904)247-5826 Fax(904)247-5845 I Ce-t-(. _ 7- 1
1 G4-
JOB ADDRESS:
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NEW O pR/ItE f,ACElytFly71 INSTALLATION: Project Value$
1�7'pYF�OFFFF-.Fv'—�RS� grx Trne OrrUTURE err
Bathtub
Clothes Washer Septic Tank&Pit
Shower
Dishwasher Sbower Pan
Drinking Fountain '— Slop Sink
Fl000r Sink -- Three Compartment Sink —`
Hose Bibs -- Toilet
Kitchen Sink Urinal
Laundry Tray Vacuum Breakers
LaystorY Water Connected Appliances
Z Water Heater
Other Fixtures Water Treating System
MPIPE:
1YPE0FFMT1JW QTy TYPFOFF/XTU" QTY
Bathtub
Clothes washer Septic Tank&Pit
Shower `
Dishwasher Shower Pan `
Drinking Fountain Slop Sink '
Fl000rr Drain Toilet Three Compartment Sink
Floor Sink P '
Hose Bibs ' ._
Lateen sink urinal
Laund .� Vacuum Breakers '
lAvamry Tray Water COnnacted Appliances
Other FxtmasWater Heater
—_ Water Treating System `
(ISCELLANEOUS:
3CWer Replacement ❑ Back Flow Preventer ❑ Grease interceptor('Crap)_gallons(Requires 3 sees of plans)
Lawn Sprinkler System-Number of Heads ❑ Well r•
`,SIRWD We"Compl8itOn FOrrrt.COmPlete�be submitted to tiding Department for final inspection.**
Other
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wbcihcr speeiflcd
permit does miniere snhori�Wolatcffie visions ofany oils strtc ar loml law rcaularia dnstwctlon or the perfa[mmce ofdaseuotion.
Verty Owners Name .Johh NZ i�/V•C-
// Phone Number
msbing Company.4 RA'Aie— el /tile�ih Office Phone 1f7—,TZ
Fax S, 930
. Address: e 4 /✓G- -" City State 2L--/zip ,3.222
vase Holder(Prlat): iJia_.1RS rf)
atitm/RCgisttation# :fFcro SOS
idtrirsd Signature of License Holder
Before me this day of 20 /L
LINaSAVBELMONr
® LW OOMMISswN eR 14am2 Signature of Notary Public
E)WIBES:JAN12, 020
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