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Permti 185 Poinsettia Street CITY OF ATLANTIC BEACH SS 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 0 jilt Application Number . . . . . 10-00000547 Date 5/03/10 Property Address . . . . . . 185 POINSETTIA ST Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc REPIPE ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ ANDERSON DEAN SCOTT STEEG PLUMBING 18S POINSETTIA STREET 1601 MAIN STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 249-5191 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . REPIPE Permit Fee . . . . 139 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/30/10 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 139 . 00 139 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 139 . 00 139 . 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 1_ PERWY Zo JOB ADDRESS: A-5- '111�euc-lo - NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE oF FIXTURE QTY TYPE oF FixTup.E QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Dram Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry"fray 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: El Sewer Replacement o Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans) 1:1 Lawn Sprinkler System-Number of Heads Ei Well ** SJR WD Well Completion Form. Completed form to be submitted to the Building Department for fmal inspection. Ei 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 authori to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name Phone Number Plumbing Company C_ek, —Office Phone Fax State &zip 3A .7-7, Co. Address: _v A9 city Li Or rq _�Ac 1-4 State Certification/Registration# _Z D634126 Ider No 4091RUNgose 4.6.,r 1461. e,4 Bwded Thru Notary Pubft UndarAnftts dayof 2(Y"D Sworn nd) bscribed belore yte 41i P 2— 1 — Signature of Notary Public MA���W_