Permit Plbg shower pan 193 Beach #2 2010 t , S , CITY OF ATLANTIC BEACH
''' . 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
' 1131
Application Number 10- 00001300 Date 10/25/10
Property Address 193 BEACH AVE 2
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
shower pan replacement
Owner Contractor
* * * * *SHORECREST * * * * ** AMERICAN PLUMBING CONT. INC.
%R.K.PROPERTIES, INC. 5720 ARLINGTON RD
599 ATLANTIC BLVD. JACKSONVILLE FL 32211
3223 (904) 591 -5385
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 62.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 4/23/11
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG 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 WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Oct. 25. 2010 3:11PM AMERICAN PLBG CONT INC 743 - 9944 No, 5814 P. 1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 ;
Ph (904) 247 -5826 Fax (904) 247 -5845 .' - /''
TOB ADDRESS: //)— tee-Weld eld 4 leg, 2 _ PERMIT #
NEW OR REPLACEMENT INSTALLATION: P roject Value $ 1 5 5 a- C
TYPE OFFJxruieE Orr TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan t/
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 FrxrURE QTY TYPE OF FarzatE Orr
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher _ Shower Pau
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
MISCELLANEOUS:
o Sewer Replacement ❑ Back Flow Preventer 0 Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
0 Lawn Sprinkler System - Number of Heads o Well •*
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for ftua1 inspection.**
o Other
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 a ority to violate e provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name iisz Phone Number. 334 ?in-- _
Plumbing Company �� T krJW1 ' G _ Offi Ph 7q - J ' 3 Fax W3-111W
P / �
Co. Address: ,0+. /. o w t _i , ity . c State 61 zip 9-. 4
/
License Holder (Print): i3 ) • ' f►fif State - - gistration # erCOSIAPV
Notarized Signature ofLicens - Ter
nO1..Y'; P E J C S T T O F F • • DA
,,..° Sworn and s - • • efore m� t ' 1%1 d.,! of o c 6er 20
( ,,,; I =Coxlr K;m I.assiat ' � • ission #DD761 7 . rte / —
321 - ' Expires: APR. 08, 2D12 . t iature of Notary Public .:. � .
8O \O THR(1 AT \'t7C BONDAG co, . INC.