1085 Atlantic Blvd bldg 6 59-68 2012 CITY OF ATLANTIC BEACH
sl 800 SEMINOLE ROAD
r� ATLANTIC BEACH, FL 32233
v INSPECTION PHONE LINE 247-5814
Oil �?
Application Number . . . . . 12-00001603 Date 10/30/12
Property Address . . . . . . 1085 ATLANTIC BLVD BDG 6
Tenant nbr, name . . . . . . BLDG6 UNITS 59-68
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
Water Heaters
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Owner Contractor
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1085 ATLANTIC LLC ADVANTAGE PLUMBING
5118 N 56TH ST 880 MAYPORT RD
TAMPA FL 33610 ATLANTIC BEACH FL 32233
(904) 247-9848
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Permit . . . . . . PLUMBING PERMIT
Additional desc WATER HEATERS 00
Permit Fee 125 . 00 Plan Check Fee
Valuation
Issue Date
Expiration Date . . 4/28/13
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__ ---------------------------------
Other Fees
STATE PLBG DCA SURCHARGE2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
_ ________ ----
Fee summary Charged
Paid Credited ----Due---
. 00
_ _ ----------
----- ----------
- . 00
Permit Fee Total 125 . 00 125 . 00 00 . 00
Plan Check Total • 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00
Grand Total
129 . 00 129 . 00 . 00 . 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 Fax (904) 247-5845
Jas ADDRESS: L, LD PERMIT#
1I �
NEW OR REPLACEMENT INSTALLATION: Project Value$
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 ❑ Back Flow Preventer ❑ 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."
❑ 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 2 4=,F Phone Number
Office Phone e:%412--MV<9 Fax
Plumbing Company
Co. Address: (� City ��-- State�Zip 3223
License Holder(Print): State C rtification/Registration ,C
Notarized Signature of License Holder.
DEBOPM AMAWA w
before this day 20
V, MY COMMISSION#
o
EE 05599 n re
f Notary Public
EXPIRES:May 21,2 g Y
o ;d;: Bonded Thru Notary Public Underwriters