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Permit Plbg Repipe 2010 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00001125 Date 9/13/10 Property Address . . . . . . 500 CRUISER LN Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 12 fixtures ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ GILL, JR. , BEN W. DAVID GRAY PLUMBING INC. 500 CRUISER LANE 8850 CORPORATE SQUARE CT. ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216 (904) 744-7255 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 139 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/12/11 ---------------------------------------------------------------------------- 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. Mar 08 10 12:54p Information SystemsCITY 0 904-247-5845 P.1 PLUMBING PERMIT APPLICATION CITY OF ATLANTTC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904)247-5826 Fax(904)247-5845 JOB ADDRESS: L-0— PERMT# NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE oF FDrmRE QTY TYPE oF FixruRE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Sbawer Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Layatt�ry Water Heater Mar-Fixtures Water Treating System RE-PIEPE: TYPE oF FbauRE gry TYPE oF FWvRE QTY 'Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher ShDwerPan Drinking Fountain Stop 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 IMSCELLANEOUS: o Sewer Replacement o Bark Flow Preventer C3 Grease Interceptor(Trap) gallons(Requires 3 sets of plans) 11 Lawn Sprin1der System-.Number of Heads o Well **SJ)ZWD Well Completion Form. Completed form to be submitted to tFe—Building Department for rmal inspection." o Other Permit bocornes void if work-does not cornmence 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 End correct. All provisions of laws and ordinances govarning this work will be compliedArith whether specified or not. The pennit does not give authority to violate the provisions of any other state or local law regulation construction or the perfonnance of construction. Property Owners Name (�� I( Phone Number. 5 19 - Ct�S 11 Plumbing Company Davi"ray Flumlmng, Inc. Of F1 ce,Pho ne -7,6C,-7 Z,!;:r Fax Z9,-X-Jrid 8W cowul me squam ecurt Co. Address: Jarksonvillet, Plorida 32216 city State—Zip License Holder(Print): /2wla 41;�- State Certification/Registration 0 ere 0;L-X-,6rU ool - Notarized Signature of License Hvider Zk�4—I- Sworn and subscribed before me thi 4yof 201 Signature of Notary Pubfic 11 Lor -T— ry U U lic state of Florida Nz;ry=', (i� Neeal Rmajor 05W 0'c is mm 560 My commission D0602 a k4 's ,-d; X ires 12J 01 010 12J2012010 Ex ires