1734 Maritime Oak Dr plbg permit A CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
,. r ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
F_
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMATION:
Job ID: 17-PLBG-3057
Job Type: PLUMBING ONLY
Description: install 25 fixtures
Estimated Value:
Issue Date: 1/20/2017
Expiration Date: 7/19/2017
PROPERTY ADDRESS:
Address: 1734 MARITIME OAK DR
RE Number: None
PROPERTY OWNER:
Name: RIVERSIDE HOMES OF N FL
Address: 414 OLD HARD RD STE 502 MATTHEW ROBERTS
GENERAL CONTRACTOR INFORMATION:
Name: NELSON PLUMBING CO. INC.
Scott Nelson,CFCO20379
Address: 11624 -1 DAVE DAVIS CREEK RD QA SCOTT GARY
NELSON
Phone: - -
FEES:
Plumbing Fixtures $175.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $234.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 (l_PLS
JOBADDRESS: I-W ffilke lcll lC 61L QYL PERMIT#Ik-SAL-283(
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPEoFFIxTURE QTY TYPEOFFIXTuRE QTY
Bathtub t 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 -I
Lavatory _ 7 Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPEOFFtxTORE QTY TYPE of FIXTURE 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 '*
** 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
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 in violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name_ �iyegZQs y. Phone Number
Plumbing Company /A�EGS'r...+ P[lt YNBiM)6 . Office Phone 7L 2.Y88 KFax
t C i 22
Co.Address: : t3' State zip
License Holder(Print): e C e ffcation/Registration lY g
Notarized Si nature of License Holder
Myssror rFymaz Belo methis day of /l 20 _
a'. WIRES:Naosatxr 16,2019
axmrsmrauvcws:um. r Signature of Notary Publi
s