92 13th Street West Permit Plbg 2010 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
-5826
INSPECTION PHONE LINE 247
Application Number . . . . . 10-00001217 Date 10/06/10
Property Address . . . . . . 92 W 13TH ST
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
1 FIXTURE
-------------------------------------------------------------------- -------
Owner Contractor
------------------------
------------------------
EVANS DAVID GRAY PLUMBING INC.
8850 CORPORATE SQUARE CT.
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
(904) 744-7255
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 4/04/11
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 62 . 00 62 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 66 . 00 66 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITIt ALL CITY OF ATLANTIC 13EACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Oct 05 10 02:12p DAVID GRAY PLUMBING 904 723 5668 P.1
Mar 38 10 12:54p Info-matior SyszzernsCITY 0 904-247-5845 P.1
PLUMMING PERMIT APPLICAT' ION
CITY OF ATLANITC BEACH
800 Seminole!Rd Atlantic Beaah,IFL 32233
Ph(904)247-5826 Fax(9D4)247-5845
JoB AiDDREss: f?/Z PERN[IT
NEW OR REPLAtENMNT INSTALLATION: Project Value
TYPE OF FD:rURE Q77 TYPE OF FEVrURE QTY
Bathtub Septic Tank&Fit
Clollizs Washer Sho-wer
-DwMamher Shower Pan i
Drinldng FountaLin
Floor Drain �=Lparltmenl Sink
Floor Sink Toilet
Hoseftibs Urbnl
Kitchen Sick Vacuum Breakers
Laundry Tray Water Connected Applim=s
La, Water Heater
Water Treating System
TY7,E oF. Fa=AE QTY TYPE op FLrruR-F QTY
Be.htub Sepdc Tank&Pit
Clothes wasber Shower .
Dishwasher Shower Pan
Drinking Fountaim SLop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Flose B ibis Urinal
Kitchen Sir* Vacuum Bf p�qtk--rs
Laundry Tray Water C Dw=tad Appl i arices
Lavatory Waur Hea±er
otherFixtures Water Treating Systern
YMCELLANEOILTS:
C1 Sewer Replaceme-ni o Back Flow Preventer 0 Gr--ase Interc;,Vtor(Trap) al.ons(I;tzq
_g i, 3 sets of pla=)
Lawn�px��ler Systam-*=�ber dlieacl-s WeE
SJ)UFD Well Cwnp1q,,- Fo
,,;Ipn orm. Completed form to bie subraitted to the Buildmg Departrne:nt for final inspecItion.
I/ -P 4-
ciOther '40e 85 e? i2of ly 9
P=rnft bccom=s void if work does not cammcn=wiibin a six mooth period or wask is siaspendtd or abandance for six months.12irreby cc.-L-ift. Lhas.I kmve
L
WL
cation and]maw th-&=c to he Inm mmd correct. AIJ pmvL%-ousofJzws mad ordirm=s Cov=ning this vmrk will becompued wie7whedier spcc-Lfi�
o, not. The p=rtnit does-not give mirborhy-m vi521nte the pnviisians of any other state or local law re9wation oom-=Uction or C,=PCrformanca of constwcfim
P--operty Owners Name Phone Mmber
JJ- J!?QA6
Phimbiney Ccmpany 900 ray Plumbing, Inc. -;FA:r -7-;�3rS-6,0?
.> 899b Corporate squale coul t Office?hot= 79';�f - -�r Fax
Co.Address: -Jar.-k-snnAo Rarida 3221f; city Stax-, zip
License Holder(Print): J?'yJ-q X- -State Certificationaegistrador, -e)g 0AXSW4
Notitmed Si6mature of License HoLder
Sworn and subscribecl xe rut�tms dp�y of 4-In P- 20 /6
Signature of Notary Public
.-�N �-Pubfic State of Florida
Neei R M*-
My Comrrissw DD602560
X
�'J