570 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
]OB INFORMATION:
Job 10: 17-PLBG-3605
Job Type: PLUMBING ONLY
Description: install 21 fixtures
Estimated Value:
Issue Date: 3/28/2017
Expiration Date: 9/24/2017
PROPERTY ADDRESS:
Address: 570 COASTAL OAK LN
RE Number. None
PROPERTY OWNER:
Name: TOLL FL VI LIMITED PARTNERSHIP
Address:
GENERAL CONTRACTOR INFORMATION:
Name: DARLEYS PLUMBING INC.
,CFC056702
Address: 4472 PHILLIPS HWY QA CARL LESLIE DARLEY
Phone: -
FEES:
Plumbing Fixtures $147.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $206.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
1l
') PLUMBING PERMIT APPLICATION
r �1 CITY OF ATLANTIC BEACH
t,4 J 800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JoB ADDRESS: 5 7y Co 4sr+ ore. L-q-•f PERMTr#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPEOFFVCMRE QTY TYPE OFFTXTURE QTY
Bathtub z Septic Tank&Pit
Clothes Washer I Shower
Dishwasher I Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink — Toilet
Hose Bibs � Urinal
Kitchen Sink r Vacuum Breakers
Laundry Tray 1 Water Connected Appliances ^e-
Lavatory Water Heater I
Other Futures Water Treating System I
RE-PIPE:
TYPEOFPLCTURE QTY TYPE OFFhTORE QTY
Batbmb Septic Tank&Pit
Clothes Washer Shower
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 Funnies Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement 0 Back Flow Preventer i7 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
i7 Lawn Sprinkler System-Number of Heads ❑ Well **
**S1RWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection.**
❑ Other
Permit become void if work does not wmmenm within a six mooth period or work is suspended or abandoned for six months.I hereby certify Ose[I have reed
this application sod lmow the snare to be me and correct All provisions of laws and ordinanees governing this work will be complied with whether specified
or ant The permit does not also authority to violate the provisions of any other srete or local law regulation Construction,orthe performance ofweestrucnon.
Property Owners Name //a ,1"s Phone Number
Plumbing Company UAOL,� P r•. 4i..c OfficePhone 72-7-/l/9Y Fax 72 7-/Y er
Co.Address: yN71 pH -.T4s l{try city ,Yft State6:Zip hzc7
License Holder(Print): C442- L. a Certification/Registration#Cie• C0�6-
Notarized Signature of License Holder
Beforeme this day c 20
JORNNE MEHL
�: Nmay public-sure of trotiaa Signature 4f Notary Pt h�lr _ --
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