589 Coastal Oak Ln 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
IOB INFORMATION:
Job ID: 17-PLBG-3299
lob Type: PLUMBING ONLY
Desaiption: install 31 fixtures
Estimated Value:
Issue Date: 2/21/2017
Expiration Date: 8/20/2017
PROPERTY ADDRESS:
Address: 589 COASTAL OAK LN
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 DAV E DAVIS CREEK RD QA SCOTT GARY
NELSON
Phone:
FEES:
Plumbing Fixtures $217.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $276.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 nFax(904)247-5945
JOB ADDRESS: S9 I6 „eORSTA OAA , Loy PERMIP#lJ-SF2-30Y7
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPEoplba'um QTY 7YFE0FFDTURE QTY
Bathtub 1 Septic Tank&P8
Clothes Washer
Dishwasher' I _ SShower Pan
FIFounrdin STS CMompanment Sink
Floor Sink - Toilet
Hose Bibs Urinal
Kitchen Sink �_ Vacuum Breakers
Laundry Tray Water connected Appliances
LavWaterHeater _7-
er u�tcsF _� Water Treating System
RE-PIPE:
TFPEOFFhwvitE QTY TYPEOFFATURE QTY
Bathtub SepBc Tauk&Pit
Clothes Washer " Showa
Dishwasher Mwer Pan
Drinking Fotmiain Slop Sink
FloorDram Three Compartment Sink
Floor Sink Toilet _
Hose Bibs Urinal
YU0,Sink Vatxiuun Breakets
Laundry Tray Water Connected Appliances
Lavatory WaterHealer
Otl ixtmesF Water Treating System
MISCELLANEOUS:
O Sewer R rlacemerat ❑Back Flow Preventer o Grease Interceptor(Trap) gallons(Regaim 3 sen of p4
D Lawn Sprinkler System-Nimtber of Heads ❑ Well "
i
"'&&WD Well Completion Form.Completed form to be submitted to the B Bdng Department for final inspector
o Other
Permitba void ifwmkdwsnotcommmrrwhhmasixmovth Pmwdwwork%suspended crabandoned for sixmonths Ihereby certify that I have
Swapph0 andlmawthe—wbat mdaarea. Aapmvmansofia mdadm govcmmgttswo&wMbecomplwdwObwh-th"g)ecil
ornot Thu permitdocs int give authority m violme the prowsiws ofany otba stares 1001 law regulaaw c0n.4mmon mtheperfumenx ofconsttucdc
Property Owners Name Qn vEl2S t DE H O Me? Phone Number
plumbing Company /AFI<nr/ PLutn g;A4 �o ?.r�L Office Phone III-4 08 N Fax
Co.Address: - 11 Ci • r� State , zip z;y
License Holder(Print): O cation/Regisnation# O 7
rcense older I' �
M!COAIMISSIONtFF90lpAt m(.0, 2017
y"y E%P�RES:NwemEar 16,2019 $WOm end SnbS '}I beforel d. 1
},,yx.W.„?C' BmLM1nry NYf PuEk Wemaq (�vv
Signature of Notary Pub