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1680 Maritime Oak Dr plbg permit 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-3183 Job Type: PLUMBING ONLY Description: install 22 fixtures Esdmated Value: Issue Date: 2/6/2017 Expiration Date: 8/5/2017 PROPERTY ADDRESS: Address: 1680 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 $154.00 State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Trade Permit Base Fee $55.00 Total Payments: $213.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. C./ PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH Soo Seminole Rd Atlantic Beach,FL 32233 Ph(904)247-5826 Fax(904)247-5845 JOBADDRES4: tGBO rA*iQ-rivAE Ofrk, Dw PERMTT# 5Fe-Z64S NEWORREPLACEMENTINSTALLATION: Project Value S TPPEOFFDavRE QTY TrPEOFFIXTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower —2 Dishwasher Shower Pan DrinkingFloor DramFotmtam SIT OWMamu.-t Side Floor Sink Toilet Hose Bft �� Urinal Kitchen Side �_ Vawlrm Breakers Landry Tray Water Connected ffi AppliancesLavatory Water Heai O g'barm Water Treating System RE-PIPE: TYPE OFFaTuRE QTY TIPEOFFIXTORE err Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shbwer Pan Drinking Fountain Slop Sink Floor Dram Twee Compartment Sink Floor Sink Toilet Hose Bros Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Come ted Appliances Water Heater Ot N'ttaes Waterer Treating System MISCELLANEOUS: ❑ Sewer Replacement O Back Flow Preventer o Grease Interceptor(Trap)_Simons(Btgtraes 3 sem of Pla o Lawn Sprinkle'System-Number of heads ❑ Well `• *� VR WD Well Completion Form.Completed form to be submitted to the—`IBm t�mg Department for final inspection o other Permit becomes void 1workd=not con whhin a six mm*paiod w work is suspended m abandoned for s&moans.I hereby catKy marl have thn apptiw¢m and Imowtbc same m beu w aademteG. All pmvisioos of laws and m h==govamaadds Work will be complied whh Whether spea anon Ibe pemut des not give aodwntym violate the pmvia;'w'lIs Of MY other starca lows law regdatoo wnWoaauo m the pafotmaom ofcoostwdc property owners Name [ i j1:-79'i DE ri o N+E S Phone Number PltmbingCompenyA)Cr dw PL(4#Xb1'A)t, �D :LNC . Office Phone ZQ -YBEC Fax eo.Address: I tk-1 UL% p?l4 t i StateJ�zip L10 License Holder(Print): o CertificationMegistratioa# 0 29329 e Holder r .. : .""n.:, Mr ca anSSIMORsoosts and da of YP�/ufe� V 201}- ` 1 sxPIReS:Nwannar,s.zo,s Swomandsabseibedbeforeme > Y ..� ammmmxow�uea.na rl�—�— , t Signature of Notary Public A n Y