1203 Fleet Landing Blvd plbg permit rl y1,Jr�,,
CITY OF ATLANTIC BEACH
r 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
108 INFORMATION:
Job ID: 16-PLBG-2571
Job Type: PLUMBING ONLY
Description: PLUMBING - 2 FIXTURES
Estimated Value:
Issue Date: 11/15/2016
Expiration Date: 5/14/2017
PROPERTY ADDRESS:
Address: 1203 FLEET LANDING BLVD
RE Number: LOC ID-0000
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BLVD
GENE RAL 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.
NW-15-2016 22:47 From: To:9042475845 Pnae:1/1
PLUMBING PERMIT APPLICATION
CITY OF 4,TLANTIC BEACH
800 Seminole k A Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845 (Co - P c,4(%-z S7
JoB ADDRESS: 003 kPERMIT is
NEW OR REPLACEMENT INSTALLATION: Project Value s
TYPEOFFZxTURE QTY TYPE orFrxTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Fluor Drain Throe Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink y Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE or.FLxTuRE QTY V TYPBoFFaruire 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 Z
Lavatory Water Heater
Other Fixtures Water Treating System
YIISCELLANEOUS:
3 Sewer Replacement ❑ Back Flow Preventer ❑ 3mage Interceptor(Trap)^gallons(Requires 3 sets of plans)
I Lawn Sprinkler System-Number of Heads ❑ Well
r"SJRWD Well Completion Form.Compl orm t be submitted to the wilding Department for final inspection.**
i Other
wink hecomes void if work does not commence within a six month p iod or work Is suspended or abandnned For six months.1 hereby witty ty the I have read
its application end know the same to be we and c i. All provision of laws and nrtnnunces goveming this work will be complied with whether specified
r not. The permit docs not give euthorhy to violate the provisions ora y other slate or local law rcguieion construction or the perhoi mace offcoonerucMaon.
'roperty Owners Name Ury1\1 Phone Number CD
'ltunbing Company (.. Oflice phone 9 -ACJ' f1 ax Z
'o. Address: 5 6 �1— city Qrglbka n state 'zizip 37ol1
Acense Holder(Print]: CYinS'ka ht.- co, h) State Certification/Registmtion# CFG05'?SOq
folartzed Signature ojLicense Holder
LfkN.., Nathan P.Tudter Sworn and subscr before m his �Jr etyi&&_ 20 /(y
Cartmissim$FF1ti24t6 �^
.,z"�.v =F�ires:AUO*1Y101! Signature ol"Notar Public