1670 BEACH AVE - PLUMBING f S
\ � CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
s)
J � 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-3368
Job Type: PLUMBING ONLY
Description: install one fixture
Estimated Value: $300.00
Issue Date: 2/28/2017
Expiration Date: 8/27/2017
PROPERTY ADDRESS:
Address: 1670 BEACH AVE
RE Number: 169570-0000
PROPERTY OWNER:
Name: ESHELMAN, THADDEUS 0
Address: 1670 BEACH AVE
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
FEES:
Plumbing Fixtures $7.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $66.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
02/28/2017 09:26 FAX 9046459363 atlantic-coast 2 001
05-06-16; 10; 14 ;From: To:96459363 ;9042475845 i# 1/ 1
PLIJ I3I G PERMIT .APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 217-5845 1- - QL BCS— - 3(P g
JOB ADDRESS: ./C'70 /Se./ /4 /,// V PERI Xrr#
NnW OR REPLACEMENT INSTALLATION: Frojeet Value$ ;300. 0(
TYPE of FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer �,,,, Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sinkc
Floor Drain Three Compartfnent Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures .. Water Treating System
-P1P'E:
TYPE OF F'1X7"URTs QTY TYPE OF FixrwtF 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
K.itohen Sink Vacuum Breakers
Laundry Tray Water Connootod Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
UXSCCLLANEOUS:
Sewer Replacement El Back Flow Preventer o Grease Interceptor(Trap) gallons(Recautres 3 sets of plans)
Lawn Sprinkler System-Number of Meads Cl Well **
'SJRWD Well Completion Form. Completed ig-n.to be subxnittcd to tglifiding Department for final inspection,**
Other
mit becomes void if work dons not commence within a six month period or work is suspended or abandoned for IN months.I hereby certify that T have read
application cod know the seine t0 be true Wild correct All provisions of laws and ordinances governing this work will be complied with whether specified
:ot. Tho permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of oonstruotion,
sporty Owners Name �1/9.1 4 7?7/94/ Phone Number. - d v 7-379.' .
imbing Company A/'/An/ lei Co q SI- AUrn.b471 Office Phoone Cd J'J•3:Z7,Fax_6 � �3C3
. Address: ....5'3 'itt r 6/V Zi Sof / City____________. State /1:':'/Zip 3. v2
;eusc T4older(Print); /11/ Jird'/;.0-J ar,` ;.- ' ati. 'egistratiori# G'frGo 510 5.1'
tarizs'd S'ignature of License Holder ARRAS 111=1.4111 -
Before me this, ,, day of - ` , , 20
LINDSAY BELMONT
• MY COMMISSION*FF9498O2 Signature of Notary Public �w!._�. c
'"" EXPIRES.JAN 12,2020 d
Bonded through 1st State Insurance
�� i ATLANTIC BEACH
\SS1
t -i►.+' l
--'' ' ' �` ' PERMIT RECEIPT
„ -r •
'`.1.-1:-.0.211).,-* February 28, 2017
PERMIT DESCRIPTION: install one fixture
PERMIT NUMBER: 17-PLBG-3368
ADDRESS: 1670 BEACH AVE
OWNER: CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
Plumbing Fixtures $7.00 02.28'2017 123840
CREDIT CARD _
State PLMG DBPR Surcharge $2.00 VISA SALE
CARD; XXXXX)WW(XX5358 _
State PLMG DCA Surcharge $2.00 INVOICE 0001
SEQ;: 0001
Batch u: 000507 _
Trade Permit Base Fee $55.00 Approval Code: 013845
Entry Method: Manual
Mode. Online —
Taa Amount. 50.00 —
Totals: Card Code: M
$66.00
SALE AMOUNT 566,00
CUSTOMER COPY