Permit Sewer 65 Shell St 2011 ,,;: I ,vv,
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ej A , ,;‘ r s� CITY OF ATLANTIC BEACH
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r ) 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
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Application Number 11- 00002419 Date 8/01/11
Property Address 65 SHELL ST
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
new sewer line
Owner Contractor
VERMEY, GERARD CHRISTY FIRST COAST PLUMBING
65 SHELL STREET 1651 MAYPORT RD
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 247 -4419
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 62.00 Plan Check Fee .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 1/28/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 62.00 62.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 66.00 66.00 .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 a
Ph (904) 247 -5826 Fax (904) 247 -5845
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LP 5 5' uU��t
Jos ADDRESS: Whit
PER1vIIT # -
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:
o Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
o Lawn Sprinkler System Number of Heads 0 Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
other OW 'so I M12. irtW l C/ OftvdteL gitejiCir
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 ority to violate the provisions of any other state oi< local law regulation construction or the performance of construction.
Property Owners Name Phone Phone Number �
Plumbing Company CH K-t 5t' ItS ())( P m) ' Wee Phone 6Z 41 - 44 19 Fax agq-466(7
Co. Address: 1('51 I4calpo f L004 City !h'jantiC beachState *_ Zip 5d
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License Holder (Print): ' 0 . " ' S ertification/Registration #
Notarized Signature of License ; o ' r 4 f,aiip
,,,. _ Sworn and subscrib fore me this day of U 20 l
,. ti, JUUEYOUNG CHRISTY ""� /
= . + "` MY G'OMMISSION # DD 873293 Signature of Notary Public I /.4.0 r
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� ;:;, . EXPtRE3: July 21, 2013
4Rf 44__ Bonded T Notary public ■
White, Debbie
From: Walker, Chris
Sent: Tuesday, August 02, 2011 8:41 AM
To: Kaluzniak, Donna
Cc: White, Debbie; Ramsay, Debra; Graham Shirley; Matthews, Carlene
Subject: 65 Shell St
I inspected this sewer tie in yesterday and everything is good here. They are now tied in.
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