Permit Plbg Relocate water svc 645 Atl Blvd 2010 -51I�'lrk I
IS1 CITY OFA ATLANTIC BEAC
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
• ►� INSPECTION PHONE LINE 247-5826
APPlication Number
Property Address
Application 10-00001294
type description 645 ATLANTIC BLS Date 10/25/10
Application
Zonin Ption PLUMBING ONLY
---___PPlication va g valuation TO BE UPDATED
ATED
Application desc '-------- 0
----__back- flow_preventer- ---------------------------------------
Owner__--__-_ --'--------------------------------------------
FLORIDA WINE - Contractor
645 ATLANTICCLUB, INC
- ---- ___
BLVD. CHRISTY
ATLANTIC BEACH FIRST COAST PLUMBING
FL 32233 P.0' BOX 50446
--- JAX BEACH
Permit -
(904) 247-4419 FL 32240
Additional desc PLUMBING PERMIT----------------------------- ---
Permit Fee ---
Issue Date 62 . 00 Plan Check Fee
Expiration Date Valuation 00
----------------- -----------------------------------------------------
4/23/11 on
Other Fees ------------------------------ - 0
-----------------------------
--_ STATE PLBG DCA SURCHARGE ---------------
--- STATE PLBG DBPR SURCHARGE 2. 00
2 . 0
Fee summary--------charged -------Paid --------------------------------
---------- -----62--- ----- --- Credited
Due
Permit Fee Total . 00 2 ---------- ----------
Plan Check Total 62 ' 00 . 00 . 00
. 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 66. 00 ' 00 . 00
66 . 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 ATL
800 Seminole Rd Atlantic BEACH-I
Ph (904 is Beach, FL 32233
JOB ADDIMSS; )247-5826 Fax(904)247-5845
NEWOR PL ................................................................
ACEMENT INSTAL
TYPEOFFiXrUME
PERMIT#
CATION; Project V
Bathtub QTY aloe$
ClothesTYPE OF _1—�—
Dishwashersher FLyrURE
Drinki -______ Septic Tank&pit QTY
ng Fountain Shower
Floor Drain Shower Pan
Floor Sink �- Slop Sink ----_
Hose Bibs ----___ Three Co
Kitchen Sink Toilet mpartment Sink
Laundry Tray Urinal
Lavatory Vacuum Breakers
Other Fixtures Water Connected Appliances
Water Heater
�'pIPE' Water Treating
System —
TYPt;ol<FfXrURE
Bathtub QTy
Clothes Washer TYPE oFFixTURE
Dishwasher Septic Tank&pit QT y
Drinking Fountain Shower
Floor Drain Shower Pan
Floor Sink Slop Sink
Hose Bibs l t Compartment Sink
Three
o
Kitchen Sink -- Urinal
Laundry Tray Vacuum Breakers
Lavatory Water Connected Appliances
Other Fixtures Water Heater
Water Treating System
41SCELLANEOU : 1�5 lJ
I Sewer Replacement ack Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans
Lawn Sprinkler System-Number of Heads ❑ Well
*sm*D Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
Otherl� f�r'
W'ttllin&six month period or work is suspended or abandoned for six months.I hereby certify that I have read
1 h whether s eci ied
I �
i
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
L/G/ Ph(904)24,,7-5582,6 Fax(99,?04))247-5845
JOB ADDRESS: � 7 5_ a�q l f�L �O�Ul� , Cti/O/ PERMIT# lb-
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 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 FIXTURE 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
MISCELLANEOU�Back
//l.brf
❑ Sewer Replacement Flow Preventer ❑ Grease Interceptor(Trap) a
gallons(Requires uires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well
** VRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
VOther jr'1C �
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 vvCom/iolateet�the,^,provisions of any other state or local law regulation construction or the performance of construction.
tandProperty Owners Name ' Phone Number
Plumbing Company _J rJS wx6 ffice Phone 9�e_"7Y//7 Fax9 r
Co. Address: 0 SCG d�' & CityJa /i:2! StateZip�
License Holder �•Print / l0 i l (tel L,U i
Holder(Print): State Certification/Registration# &�Z 54,F/
Notarized Signature o License
9 DEBORAH A.WHI
S.
MY COMMISSION q DD u d subscribed before a this G day of 20�
Bonded ThEXPlRrbmMPuw�un21, 011
pr,... e of Notary Public