Permit Irrigation 2010 .
4 11-00,C,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 10- 00000979 Date 8/05/10
Property Address 393 1ST ST
Application type description IRRIGATION /SPRINKLER
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
393 and 395
Owner Contractor
SIRMANS CHARLYN L EARTH WORKS DESIGN &
1715 LEBANON RD MAINTENANCE, INC.
LAWRENCEVILLE GA 30043 11111 -70 SAN JOSE BLVD # 297
JACKSONVILLE FL 32223
(904) 268 -4866
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 62.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 2/01/11
Fee summary Charged Paid Credited Due
Permit Fee Total 62.00 62.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 62.00 62.00 .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
JOB ADDRESS: 3 9 3 /3 5 % f / 1-z. cr PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value $ Z 20 0 ■,,,)
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 3S' ❑ 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 StcvZ N og 6 e B Phone Number
Plumbing Company gctt 4 Oar lLS -r r ( ga..10 n Office Phone Cie - 0 ' 11 ' ) " Fax C taco ° 7)
Co. Address: ), 6D/ V 81%) City ar,--1453 V1t » 1)-e- State Fl Zip 3'). 1.
License Holder (Print): 1o5 1c in( 690 State Certification/Registration # 1;41
Notarized Signature of License Holder
,,, r ,,, ry C � � Sworn and subscribed before me this 5' day of Au5 t,45t 20 1
'c• MY COMMISSION A DD 664694 C tw Q -
r .. { = EXPRES: May 10, 2011 Signature of Notary Publi
c4, h V Bonded Thru Nolay Pubic { nderwriers
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