408 ROYAL PALMS DR - PLUMBING S ,<(,)
s f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J eATLANTIC BEACH, FL 32233
\\ >� INSPECTION PHONE LINE 247-5814
.21>r
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-PLBG-3399
Job Type: PLUMBING ONLY
Description: install bathtub & tub valve
Estimated Value:
Issue Date: 3/2/2017
Expiration Date: 8/29/2017
PROPERTY ADDRESS:
Address: 408 ROYAL PALMS DR
RE Number: 171508-0000
PROPERTY OWNER:
Name: SIMS, MARY
Address: 408 ROYAL PALMS DR
GENERAL CONTRACTOR INFORMATION:
Name: ATLANTIC COAST PLUMBING CORP.
Nicholas Arlon Parrish, CFC050590
Address: 3653 REGENT BLVD APT 305 QA NICHOLAS ARLON
PARRISH
Phone: 904-997-3278 (024E5- 7 3 (e::3 FA X
FEES:
Plumbing Fixtures $14.00 u 1 CP T C C AOL- , C O(1I
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND 771E FLORIDA
BUILDING CODES.
4 �
s; ATLANTIC BEACH
yr
PERMIT RECEIPT
March 2, 2017
PERMIT DESCRIPTION: install bathtub &tub valve
PERMIT NUMBER: 17-PLBG-3399
ADDRESS: 408 ROYAL PALMS DR
OWNER: CITY OF ATLANTIC BEACH
800 SEMINOL E RD
Plumbing Fixtures $14.00 ATLANTIC BEAC,FL 32233
03,'02 201? 11:33:49
State PLMG DBPR Surcharge $2.00 CREDTT CARD
VISA SALE
State PLMG DCA Surcharge $2.00 CARD x XXXXXXXXXXXX5358
IPJVOICE 0002
SEQ rr: 0002
Trade Permit Base Fee Batch :
$55.00 000509
Approval Code: 003354
Entry Method: Manual
Mode: Onlaie
Totals:
Tax Amount: $0.00
$73.00 Card Code: M
SALE AMOUNT $13,00
CUSTOMER COPY
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03/02/2017 09:31 FAX 9046459363
05-08-16; 10; 14 ;From: To:98469363 ;9042475845 # 1/ 1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
r Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: /(2 /0 1 aro/ r - PLG - 33 a)
PERT#
NEW 01Z REPLACEMENT INSTALLATION: Project Value$
TYPE orF,DYTt7.ez Orr 2"YTE OFF!X2-C,RE
Bathtub Q `
Clothes Washer —L.- Septic Tank&Pit
Dishwasher
- Shower
Di.sJ2cing Fountain Shower Pan �-
I�l:loor Drain
Slop Sink
Floor Sink Three Compartment Sink
Hese ribs Toilet
tchen Sink -
KiUrinalIC
then Tray Vacuum Breakers
LavatoryWater Connected Appliances
Other Fixtures 114 (/A/-e-- - Water Heater
Water Treating System
RE
PIPE; a.,•••
TYPO OF Parti..RG QTY TYPE OF FIXTURE
Bathtub Qom`
Septic Tank&Pit
CIotJ. s WasherDishw
Shower �-
D 04r in Fountain SlopSink
Shower Pan
_-�
Floor Sink ----� 'Three Compartment Sink
Hose Bibs ---� Toilet
_Kitchen S rhino!
Laundry Tray Vacuum Breakers
Lavatory ____-_ Water Connected Appliances
Other)Fx;�turea Water Heater
..__ Water Treating System
[lSC.ELL,ANEOUS:
sewer Replacement C7 Back Plow Pm/enter o Grease interceptor P (Trap) gallons(Requires 3 vets o£ptuas)
Lawn Sprinkler System-Number of Meads O Well *4.
•RSJRWD Well Completion Form. Complete:norrxi to be submitted to IMIutiding Department for final inspection,*''
Other
zit becomes void if work does not commence within a six,month period or work is suspcndW or abandoned 11 r six monthAilluimly that I have read X hccc
e plic i tt and know the not give n Borne
to be tmey to v nend
j co the t 111 ons oprovisions
of laws and ordinances governing this work will be complied withw whether specified
P any other steto or local law regulation construetlon or the performance Ofcons(nrat6On,
perry Owners Nae aed
Phone Number_ a36=-6)0 .
mbing Company II `iLd e— , S '''/(//h //7 Office Phone ,i7� 7Y
Address: C d 63
r . . 4 • ' 505
5 City -. x State f ' Zip �.?,2�
Bnsc Holder (Print): ,I �rA ,---�-----
ir- - .>-.r C rti cation/Registration# C-/-'-___.: „,./.94=7
o
arised Signature of License Holder �L�� .
Before me this .2'7'4day ofr G 20.E---
LINDSAY BELMONT
MY COMMISSION#FF948B02 Sigature of Notary Public V.{ -�-1,
(411N- EXPIRES:JAN 12,2020
Bonded tiro* 1st State Insurance