Permit Plbg Irrigation 1205 Selva Grande 2010 A i -0.:1 `,
ti CITY OF ATLANTIC BEACH
I 800 SEMINOLE ROAD
; ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
J.i3S>i
Application Number 10- 00001403 Date 11/22/10
Property Address 1805 SELVA GRANDE DR
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
irrigation
Owner Contractor
HAWKINS, JAMES D. HULIHAN TERRITORY
1805 SELVA GRANDE DR. P.O. BOX 331268
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 270 -8377
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 62.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 5/21/11
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
JOB ADDRESS: da
eSCIVI Cr?- c/ e'-- i Fl! V< PERMIT #
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:
yerR
epl acement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
n Sprinkler System - Number of Heads 3 e) ❑ Well
** L , S hey S/v„t:''''w - �`'
** 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 auth to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name •44,05 Phone Number
i ��Ah� f !� �r ._ ��C . Office Phone 7 � f Fax Z‘ z `.5 e
Plumbing Company / / ti
Co. Address: [ l 7 7 41 /21 /3fr �/ City .4 • State Zip 3 Z 2-3 j
License Holder (Print): -(' / //h l' State Certification/Registration # " s
Notarized Signature of License Holder 4 A1/21 �' -
Sworn and subscribed • for da . of a 20
1111 MP'
Signature of Notary Pus is !t _ � Ill _