1740 Maritime Oak Dr plbg permit .S L.AIJ j.
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
JOB INFORMATION:
Job ID: 17-PLBG-3056
Job Type: PLUMBING ONLY
Description: install 24 fixtures
Estimated Value:
Issue Date: 1/20/2017
Expiration Date: 7/19/2017
PROPERTY ADDRESS:
Address: 1740 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 $168.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $227.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION y�
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 ��_PL6C'1_3o,Sb
JOB ADDRESS: I-1 L{0 ffiftl .ITIYYI£ C)AK- p2 PERMIT# I(�-SF¢' 28oS
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF F/XTORE QTY TYPE OFFixTURE QTY
Bathtub ?L Septic Tank&Pit
Clothes Washer I Shower 7—
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet T
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System —I—
RE-PIPE:
TYPE OF FIXTURE 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 1 have read
this application and know the same to be one 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 constmction.
Property Owners Name 1 C v-s l o ^) Phone Number
Plumbing Company w1 tUil 1 r Office Phone V Fax
Co. Address: - VI S 69f4 L i C State�Zip ��1r�
License Holder(Print): B t ertification/Registration# 62.037'T
Notarized Si nature o L' der fi/Iff IV
= S sp.=
',4 Novemier 00212 afore me this day of h 20
S Nwwabar 16.2018wwP*xu a n. ignature of Notary Publir lam-