1686 Maritime Oak Dr plbg permit CITY OF ATLANTIC BEACH
A l 800 SEMINOLE ROAD
j � ATLANTIC BEACH,FL 32233
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INSPECTION PHONE LINE 247-5814
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PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 16-PLBG-2410
Job Type: PLUMBING ONLY
Description: install 24 new fixtures
Estimated Value:
Issue Date: 10/26/2016
Expiration Date: 4/24/2017
PROPERTY ADDRESS:
Address: 1686 MARITIME OAK DR
RE Number: None
GENE RAL CONTRACTOR INFORMATION:
Name: NELSON PLUMBING CO. INC.
Scott Nelson,CFCO20379
Address: 11624 -1 DAVE DAVIS CREEK RD OA SCOTT GARY
NELSON
Phone: -
FEES:
Plumbing Fixtures $168.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $227.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
n ,,,I1 Ph(904)247-,588216,.�Fax(904) 247-5845 0b-p(,g61 _ay (a
JOB ADDRESS: I(oQi�i 040 0 ,iM 1 .W a & DQ— PERMIT# I6 —5T�E-- P77
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE of FIXTURE QTY TYPE OFF/XTURE 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 —L Vacuum Breakers
Laundry TrayWater Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPEOFFIXTURE QTY TYPEOFF/XTURE 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 ❑ Well
**S/RWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other
remit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.l 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 Name 2;d6D c 111E 140 M Phone Number
Plumbing Company 41 . J fi 4misw('& :&C Office Phone y98s( Fax
Co. Address: 1 City Jg.Iac...1/r �� State�Zip� -ISb
License Holder(Print): q0 O Alelq Certification/Registration# 0203-79
Notarized Signature o License Holder
m
Before e this day of 0
''' Mv�'.JnIMlafilONtFFWNtY (.
Egpgr„ "wter Ifi 2019 Signature of Notary Public