Permit Plbg 364 10th St 2010 r .:L`1,r
6 A < :> CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
- 1.;) ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 10- 00001380 Date 11/30/10
Property Address 364 10TH ST
Application type description RESIDENTIAL OTHER
Property Zoning TO BE UPDATED
Application valuation . . . 5000
Application desc
addition of laundry room
Owner Contractor
BOYD, CHERE YOUNG AMERICANS HOME INC
364 10TH STREET PO BOX 24076
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32241
(904) 759 -9302
Permit PLUMBING PERMIT
Additional desc . WATER HEATER - CLOTHES WASHER
Sub Contractor . CROCKETT PLUMBING COMPANY
Permit Fee . . . 69.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 5/29/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST
CONTROL COMPANY PRIOR TO C.O.
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Roll off container company must be on City approved list
and container cannot be placed on City right -of -way.
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 69.00 69.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 73.00 73.00 .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 A /
ADDRESS: �` 4 1 I b 5 t PERMIT # /0 — / 3 4 G )
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE Qry
Bathtub Septic Tank & Pit
Clothes Washer 1 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 ___t
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: gallons (Requires 3 sets of plans)
❑ Sewer Replacement ❑ Back Flow Preventer 1:11 Grease Interceptor (Trap) g
❑ 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 authorit to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name e ere J. bid
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Sworn and su cribed before t • s day of
Signature of Notary Public , 1 4 ZGr;
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