Permit Plbg Backflow Prev. 2010 11ir r
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00001139 Date 9/15/10
Property Address . . . . . . 1261 MAYPORT RD
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
REPLACE 3/411 RPZ
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Owner Contractor
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ALEXIS DEVON THORPE WILLIAM' S BIG BOY PLUMBING INC
516 SOUTH 11TH AVE
JAX BEACH FL 32250
(904) 241-1880
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Permit . . . . . . PLUMBING PERMIT
Additional desc . . BACKFLOW PREVENTER REPLACEMENT
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 3/14/11
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Special Notes and Comments
CONTACT PUBLIC UTILITIES FOR TESTING
AND SIZE REQUIREMENT OF BACKFLOW DEVICE
2702535 OR 2475839
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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.
PLUM13ING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, Fl, 32233
Ph(904)247-5826 Fax (904) 247-5845
JOB ADDRESS: wt I Do(f PERMT#
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NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FixTuRE QTY TYPE OF FixTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
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
RE-PIPE:
TYPE OF FLYTuRE 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
MISCELLANE
0 Sewer Replacemeont"��Back Flow Preventer El Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
E3 Lawn Sprinkler System-Number of Heads El Well
SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection."
'2 1' "
o Other 7ft 6eZ R�" r-
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 Phone Number
Plumbing Company Uak'5 bOL4 Office Phone2q(-(gW Fax
Co. Address: WI-kK ,!�;oJ4
city TC—C bc�- State�L zip-3 2 2 S-0
License Holder(Print): [A�k 0 ww State Certific 1�
Nota
My COMMISSION#DD 634126
EXPIRES:May 21,2011 S orn and subscribed before rn hi day of 20
Bwded Thru Notary Pubft Undarwftrs
I Inature of Notary Public
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