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Permit Plbg 2010 NTIC BEACH CITY OF ATLA 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00001088 Date 8/31/10 Property Address . . . . . . 475 SELVA LAKES CIR Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 12 fixtures ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CASEY, BRIAN T. STEEG PLUMBING 475 SELVA LAKES CIRCLE 1601 MAIN STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 249-5191 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 139 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/27/11 ---------------------------------------------------------------------------- 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 JOB ADDRESS: /I PFRwr t NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE oF FbcTuRE QTY TiPE 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 FfxTuRE QTY TYPE oF FjxruRE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet —3 Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: 1i Sewer Replacement Ei Back Flow Preventer F7 Grease Interceptor(Trap) gallons(Requires 3 sets of plam D Lawn Sprinkler System-Number of Heads r7 Well ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.* 0 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 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 speciflec or not. The permit does not give authority to violate the provis.ons;of any other state or local law regulation construction or the performance of construction. Property Owners Name 1A 17 ?,j49J-e-4f Phone Number Ly 'op ._._ OfficePhone /91 Faxt�VI�W.9r Plumbing Compar __ _.-A Co. Address: 161) Z city A#' AV State_)9 License Holder(Print): _T1 State Certification/Registration# Mro_-3 7�%- Notarized Signature ofLicense Ho r 20 Swom and s4cribed before me this day of Signature of Notary Public