1759 MARITIME OAK DR - PLUMBING J\J'.1\
d' ? \ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
x ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
I JOB INFORMATION:
Job ID: 17-PLBG-3760
Job Type: PLUMBING ONLY
Description: PLUMBING - WATER HEATER
Estimated Value: $66.00
Issue Date: 4/13/2017
Expiration Date: 10/10/2017
PROPERTY ADDRESS:
Address: 1759 MARITIME OAK DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: AFFORDABLE WATER/KINDER INC
,JAX SPEC W-32
Address: 3760 KORI RD SPECIALTY WATER (CONS TDS QB)
Phone: - -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
I
Plumbing Fixtures $7.00
Trade Permit Base Fee $55.00
I
Total Payments: $66.00
I
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
04 K (31 c� '41-t..an ih c PERMIT# i
JOB ADDRESS: 1151 M A r i M / r..e2.0(„--1
NEW OR REPLACEMENT INSTALLATION: Project Value $ t-oles P°
TYPE OF FIXTURE QTY TYPE OF FIXTURE 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
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater •
• Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE 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
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement 7, Back Flow Preventer 7 Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
El Other
' Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read
' this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name SCorr AN1) •I E(Z.R.t jUPc-t Phone Number SS,— $$q-
Plumbin Company t1 FFD2hABLE l,VA I-E/Z Office PhoneZb2-aci7 Fa��2LD-49292-
Plumbing P Y
Co. Address: 3'710 0 KO 12-1 R04-1-Ci City JAC-k5Onv,I Ie. State FL Zip 02 Z 5r;
License Holder(Print): m R K K A • iK)t.3 0 t State Ce ification/Registration# 000 6186,
Notarized Signature of License Holder ( -..1 .
Sworn and subscribed be me this 1° day of �P 4 L- 20 17
Notary Public State of Florida
Derottry M.Devore Signature of Notary P lic
?, Mires
02/09./2021
21 081383
01� Expires 02/09/2021