1759 Maritime Oak Dr plbg permit f h%1ryr�n
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
J"69
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-PLBG-2360
Job Type: PLUMBING ONLY
Description: 24 Fixtures
Estimated Value:
Issue Date: 10/19/2016
Expiration Date: 4/17/2017
PROPERTY ADDRESS:
Address: 1759 MARITIME OAK DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: DARLEYS PLUMBING INC.
,CFCOS6702
Address: 4472 PHILLIPS HWY QA CARL LESLIE DARLEY
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $168.00
Trade Permit Base Fee $55.00
Total Payments: $227.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH 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 Ph(904)247-5826 Fax(904)247-5945 6-f Lfy,-.23 0
JOB ADDRESS: J�7 /I'IAAT-T7rvm•: 0A., Qn PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value S
TYPE oFFIXTURE QTY TYPE oFFIXTURE QTY
Bathtub 2 Septic Tank&Pit
Clothes WasherJ_ Shower s
Dishwasher J— Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs 2 Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray I Water Connected Appliances 2
Lavatory & Water Heater 1
Other Fixtures Water Treating System 1
RE-PIPE:
TYPE oFFLxTURE QTY TYPEoFFLxTURE 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 ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads 17 Well **
**SIRWD 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
M application and know the same to be nue 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 N e 5 Phone Number
Plumbing Companyk A, �0fficqPhoueqaa Fq Fax q.Z-4IC&:S—
Co.Address: lie City State Ft-zip &1
License Holder(Print): State Certification/Registration# (rhS(o-7d�
Notarized S' nature of License Holder
�w"r': JOANNE MEHL Swom and an sent before n e this 8>N day of Cir'r 20/46
r: Notary PaMic SIAte of Elarida
�d
commission*GG 021181 Signature of Notary Public
i%°�'" MY Comm.EApiMr Aua 29.2020
Bonded mro gh Nasional NMay Ann.