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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