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
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Application desc
12 fixtures
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Owner Contractor
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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
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 139 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 3/12/11
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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
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Notarized Signature of License Hvider Zk�4—I-
Sworn and subscribed before me thi 4yof 201
Signature of Notary Pubfic 11 Lor -T—
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U lic state of Florida
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