Permit 511 Ocean Boulevard CITY Oy ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
-5826
INSPECTION PHONE LINE 247
Walt
Application Number . . . . . lo-oo000564 Date 5/06/10
Property Address . . . . . . 511 OCEAN BLVD
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1567 ------------------------
-- ------------------------ -----------------------
Application desc
TUB AND SHOWER VALVE/WATER HEATER------------ ------------------------
---------------------------------------
Contractor
Owner ------------------------
------------------------ DAVID GRAY PLUMBING INC.
GRISWOLD, S .J. 8850 CORPORATE SQUARE CT.
511 OCEAN BLVD. FL 32233 JACKSONVILLE FL 32216
ATLANTIC BEACH (904) 744-7255
------------------ ---------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc 69 . 00 Plan Check Fee . 00
Permit Fee Valuation 0
Issue Date
Expiration Date 11/02/10 -------------------------
- -------------------------------------paid Credited Due
Fee summary Charged --- --- ------ ----------
------ --- ----- -----
Permit-Fee-Total 69 . 00 69 . 00 . 00 . 00
. 00 . 00 . 00 . 00
Plan Check Total 69 . 00 69 . 00 . 00 . 00
Grand Total
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Mar �)b )Z� )254P information SystemsCITY 0 904-247-5845 P.1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC ]REACH
800 seminole Rd Atlantic,Beach, FL 32233
A r%
Ph(904)247-5826 Fax(904)247-58 5
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JOB ADDRESS: :-�,) I
NEW OR REPLAC.FAMNT INSTALLATION: project Value$ bb gry
TY.-E OF FXTURE QTY TYPE OF F)XTURE
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasbar 'Shower Pan
Drinking Fountain Slop Sink
Three Compartment Sink
Floor Drain Toilet
Floor Sink -urinal
HoseBibs Vacuum Breakers
Kitchen Sink Water Connected Appliances
Laundry Tray Water Heater
LayatDry Water Treafing SYstem
CKher'Fixtures
RE-P][PE;TyPE oF FDIMRE (?Ty TYPE oF FDGVRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Stop Sink
Drinking Fountam Three Compartment Sink
Floor Drain Toilet
Floor Sink Urinal
Rose Bibs Vacuum Breakers
Kitchen Sink Water Connected Appliances
Laundry Tray Water Heater
Lavatory Water Treating System
other Fixtum
NHSCELLANEOUS: ci Grease Interceptor(Trap) gallons(Requires 3 sets of plaw)
ci Sewer Replacement o Bark Flow Preventer
-Number of'Heads o Well
0 Lawn Sprin1der System- . d to tRe-Building Department for final inspection."
** SJRWD ell Completion Form. Completed form to be supmitte ,
7 1
Q(Other --
Permit becomes does not commericc wilhin a six month period or work is suspended or abandoned for six months.I hereby certify that I have read
saincto be true and correct. All proViSiDDS of laws and ordinances governing this work will be.complied with whether specified
stru tiop
this applicatim and know the to violate the provisions of any other state or local law regulation construction or the perfqrmance of con c
or noL The pesmit does notgive"oritY I Phone Number
'-�C cr(-( LEX0
Property Owners Name 621.5
Oavi Plumbing, Inc. of(i Phone F 17-3
d4krffaff L��
Plumbing Company
8850 Corporate Square Court Ci oue- St Zip
Co. ALddress: State Certification/Registration#
License Holder(Print):
Notarized Signature of License Holder
20J
Sworn and subscribed before me this---!I of
Signature of Notary Public "X(pe" Notary Public State of Florida
Neal R Major
My Commission DD602560
OF Em�!��
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