1620 Maritime Oak Dr plbg permit 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
]OB INFORMATION:
Job ID: 16-PLBG-2408
.Job Type: PLUMBING ONLY
Description: install 21 new fixtures
Estimated Value:
Issue Date: 10/26/2016
Expiration Date: 4/24/2017
PROPERTY ADDRESS:
Address: 1620 MARITIME OAK DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: DARLEYS PLUMBING INC.
CFC056702
Address: 4472 PHILLIPS HWY QA CARL LESLIE DARLEY
Phone: -
FEES:
Plumbing Fixtures $147.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $206.00
PERMIT IS APPROVED ONLY W ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDMANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION al
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: 1610 /NAti —,v•-L C)AK Dti PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFDfmRE QTY TYPE oFFIXTURE QTY
Bathtub 2 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 f Vacuum Breakers
Laundry Tray Water Connected Appliances 2
Lavatory Water Heater I
other Fixtures Water Treating System _ I
RE-PIPE:
TYPE orFLxTURE QTY TYPE oFFLYmRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Dram Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen SinkVacuum 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 '*
**SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other
Permit becomes void if work does am commence within a sur month penod or work is suspended or abandoned for six months.I hereby certify that I haveread
Ns application and know,the some 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 my other was or local law regulation construction or the performance of construction.
Property Owners Name OL - Phone Number
Plumbing Company Office`Phone
� a h/W Fax aa.l K
Co. Address: �! �� City^-, + State ELZip -O&C �
License Holder(Print): State certification/Registration# n n!`/7�� n
Notarized Signature a License Holder
Sworn and Subscribed before t. _Z!;flys " day of Dcso d t-N- 20 /
JaANNE"T" I q" « Nourr pumtr 51M.111.1.0 Signature of Notary Publi -NI it
c• M•,I,,,,,` Commission#GG 02Va1
MY Comm.Ezpios Ao0 29.2020
- Bonded aaupN Naliona Naar Assn.