1785 Selva Marina Dr plbg permit ?11�L`Jyj
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-3049
lob Type: PLUMBING ONLY
Description: PLUMBING - 3 FIXTURES
Estimated Value: $1,500.00
Issue Date: 1/19/2017
Expiration Date: 7/18/2017
PROPERTY ADDRESS:
Address: 1785 SELVA MARINA DR
RE Number: 172019-0000
PROPERTY OWNER:
Name: RODRIGUEZ, JASON
Address: 1785 SELVA MARINA DR
GENERAL CONTRACTOR INFORMATION:
Name: OGRE PLUMBING CONTRACTORS INC
,CFC1428315
Address: 5340 Otter LN
Phone:904-312-8102
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $21.00
Trade Permit Base Fee $55.00
Total Payments: $80.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCPS AND THE FLORIDA
BUILDING CODES
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
1 pp Ph(9014)247-'5e8A26 Fax(904)247-5845 1 '7—
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JOB ADDRESS: I�OJ Se 6VQ yvtadlhq d✓IVP !PE`+RMITJ # V`C I
NEW OR REPLACEMENT INSTALLATION: Project Value$ l;p0
TYPE OFFEYTORE QTY TfPEOFFrxTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Tbree 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
RE-PIPE:
TYPEOFFLxmRE QTYTYPE OFFIXTt/RE QTY
Bathtub Septic Tank&Pit
Clothes Washer OShower
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:
D Sewer Replacement D Back Flow Preventer D Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
D Lawn Sprinkler System-Number of Heads D Well **
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
D 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 end know the same to be true end correct. All provisions of laws and ordinances govemiug this work will be complied with whether specified
or not. The pemdt does not give anthp`rity to violate thypvcgvisiotns ofany other state or local law regulation construction or the performance of construction.
Property Owners Name ---YQ ,p /� Z r V eK // Phone Number
Plumbing Company gree / y//ltt /H0 �Yl dj`aajY 'Office Phone 9a -2-9/02 Fax
Co.Address: g3N6 o4e//✓ Lame City /1 fd e /- State�Zip3'Zo6s
License Holder(Print): t C ro-e- " State Certificatio egistration# Cr( l y283(S
Notar' der
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