Permit Plbg Water Heater 1870 George 2010 l'j a _ , " SS CITY OF ATLANTIC BEACH
4-0 Y 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
.P ` O33 )
Application Number 10- 00001337 Date 11/03/10
Property Address 1870 GEORGE ST
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
WATER HEATER
Owner Contractor
JACKSONVILLE HOUSING AUTH FLINT CONSTRUCTION SVCS(PLBG)
123 8TH STREET 1419 LINKSIDE DR
JAX BEACH FL 32250 ATLANTIC BEACH FL 32233
994 -9626
Permit . . . . . . PLUMBING PERMIT
Additional desc . . WATER HEATER
Permit Fee . . . . 62.00 Plan Check Fee .00
Issue Date Valuation . . 0
Expiration Date . . 5/02/11
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.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
/J
JOB ADDRESS: l Y 70 - ? o S/, PERMIT # 3 "3'7
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
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Lawn Sprinkler System - Number of Heads 0 Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
❑ 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 authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name rr//t A (9 � (. ./fr i vs; ^ /itv f4�, •/ Phone Number 6 k91 - 3 gl °
Plumbing Company F /i�1T (co sfti,,,f Soc,,G c Office Phone 7 I . Fax 3 7,2 - 4'a //
Co. Address: 7 44 is r DEC r City if/c•- /c 44 State /C Zip 3( ?
License Holder (Print): /` �S S t 7( D'"l,' -0ff State Certification/R gistrat' 1 # AFC
Notarized = ' . o ' � �
t ;': a "• . My COMMISSION # DD 634126 r 3€44 J
..4.4. Y EXPIRES: May 21, 2011 Sw /c �
and subscribed before me this d a //
4 -. J -> iaonde! Thru, Notary Public Underwriters ( day Of 20 `
igiature of Notary Public AC.,1 . .