Permit Plbg 2010 CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00001006 Date 8/13/10
Property Address . . . . . . 1117 FLEET LANDING BLVD
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
2 fixtures
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Owner Contractor
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DAVID GRAY PLUMBING INC.
8850 CORPORATE SQUARE CT.
JACKSONVILLE FL 32216
(904) 744-7255
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 69 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 2/09/11
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 69 . 00 69 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 69 . 00 69 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Mar 08 10 12:54p Information SystemsCITY O 904-247-5845 p.1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(9044)247-5845
JOB ADDRESS: 1 -"111-7 PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oFFjxmRE QTY TYPE oFFixrURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher -Shower P
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavato Water Heater
-Other`Fixtures �y+t✓� �_ Water Treating System
RE-PIPE:
TYPE OF FD9V-AE QTY TYPE o.F Fva-vRE 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
NUSCELLANEOUS:
❑ Sewer Replacement ❑Bark 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 toviolate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name 6Vii:'7r I-1w1l'of Phone Number 7-A `g9dd
Plumbing Company —0-9-Vld Gray Plumbing, Inc. Office Phone Fax
Co. Address:_ Jat sonyll l,e, R+p�tlli elf+ City State Zip
License Holder(Print): p4wfo 4�glq-1 State Certification/Registration# C)V d,42-S 44
Notarized Signature of License Holder 2:LA /
Sworn and subscribed before me this fY day of 2Q/6
Signature of Notary Public
AW Xlt-
,of P4" Notary Public State of Florida
+P Neal R Major
My Commission DD6025W
o*+► E 'res 12120/2010
AL X_ �_OA� A-V1.1 LANTIC REACH
zuv Ri.Atilantic Be" FL 32233
Fes:(904)247-5845x
JOB ADDRESS: / CAe`,r I-Ittv PW 4 Jf/7P]Ewmn 10
ff
NEW OR REPLA CEMENT INSTALIAITON: Project Value S
TYPE or FDaVAE Q2Y TJ7ffOFF2XZVJtE QTY
Batbtub Septic Tank&Pit
Clothes Nastier Shower
Clishwasher Shower Pan
Drinking Fountain Slop
eMmaL
Floor Drain ThImpartment Sink
Floor Sink Toilet
Hose Bibs Tjrbw
Kitchen Sink Vacuum Break=
Laundry Tray Water Connected Appliances
Lavatory Water Heater
'Other FhAtIlres YAWJr Water Treating System
RE-PIPE:
TYPE OF pambw q77 TYPE of Fnaviw QTY
Balbtuib Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Plrinkiasg Fountain Stop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
How Sibs Urinal
Kitchen Sink Vacuum,1$Mak—
LaundryTivy Watiw Conne�,ct—ed-Appliaaces
Lavatory Water Heater
Offier Fixtures Water Treating System
MSCELLANEOUS:
r- Sewer RCP1We`mCUt 0 Back Flaw Prcventcr 0 Grease Interceptor(Trap)—gallons(Requires 3 sets of plass)
0 Lawn Spriuld=System-Number of Heads 0 WCE_
**SRWD Well Carnpie-don Fom.Completed foam to be submitted to the Building Department for final inspection."
0 Odler.
Permit becomes void N wordy does not comma=within a six nxwa period or work is suspended or abandoned for six maxtim I hereby certify that I We read
this amUcadon and know the same to be ave and correct. All provisions of kwa and ordbooms governing this work will be compered with vtAdw specified
or not. The pennit does not give autha ft,to violate the provisitax of arrf other state or local law regulation cooswxdon oc the performaoct of construction.
Property Ownm Name 62orr Phone Number
Plumbing Company Q§M Way Plumbing,Inc. —Office Phone
00 Corporate Squan: euu,t
Co. Address: city State Zip
License Holder(Print): phyte F.gjlw State CertificatiomORegistradan# CFS-002-JVJ6
Notarized Signature of Licewe Holder
Sworn and subscribed before me this III day of _A AAL 20/6
Sipatitne of Notary Public
Or'N Notary Public State of Florida
NMI R Major
My Cornmission 00602560
Exorm 1217012010
L-d 8999 CZL 1706 E)Nlewnld k"E) GIAVG dLC:LO OL ZL &V