Permit Gas Water Heater 1901 Sherry Dr 2010 .. ,
,,, .044,,, � � CITY OF ATLANTIC BEACH
..%'' 800 SEMINOLE ROAD
j , ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
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Application Number 10- 00001417 Date 11/29/10
Property Address 1901 N SHERRY DR
Application type description MECHANICAL GAS PIPING
Property Zoning TO BE UPDATED
Application valuation . . . 1773
Application desc
GAS WATER HEATER
Owner Contractor
BOUMAN ROBBERT & RUTH AEI INTERNATIONAL CORP.
1901 N.SHERRY DR 7709 ALTON AVE
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211
(904) 724 -9771
Permit MECHANICAL GAS PIPE PERMIT
Additional desc . WATER HEATER CHANGE OUT
Permit Fee . . . 60.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 5/28/11
Other Fees STATE MECH DCA SURCHARGE 2.00
STATE MECH DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 60.00 60.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 64.00 64.00 .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
Jos ADDRESS: 1 n OR . PERMIT # /d - / Y
NEW OR REPLACEMENT INSTALLATION: Project Value $ \T u0
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 Qry
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 ❑ 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 Ice t M Ptti\ Phone Number 64: 11-
Plumbing Company fkk" b/NS S( 0 : <,e.S Office Phone . 1 0 .`02- 1 c9 1)( Fax 1U-02c 3 M
Co. Address: �?�D9 Al.: Ac — Cit ,l , 1.1sz_ State F 1 Zip 3 3 . 221 k
License Ho! _ _ , ' • =— - i' S c c s I _ Sta • erti ication/Registration # e r�(L( 2Si 33
Notari = • • " , ttrwriV �ol /{ r � � k�'c —
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1:,,,,4 i tiV 20 / , � 1 p de =7mi Notary P - u - Undervr� • ay o f
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Signature of Notary Public
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