Permit Plbg 1737 Seminole 2010 �'' ". � CITY OF ATLANTIC BEACH
` � � j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 10- 00001462 Date 12/14/10
Property Address 1737 SEMINOLE RD
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
16 fixtures
Owner Contractor
FLOOD, WILLIAM W. MCGEE PLUMBING, INC.
1737 SEMINOLE ROAD 9937 SAGETREE CT
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32257
(904) 886 -0258
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 167.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . 0
Expiration Date . 6/12/11
Other Fees STATE PLBG DCA SURCHARGE 2.51
STATE PLBG DBPR SURCHARGE 2.51
Fee summary Charged Paid Credited Due
Permit Fee Total 167.00 167.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 5.02 5.02 .00 .00
Grand Total 172.02 172.02 .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: j 737 < J e 4, n o I Q a PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value $ 3, goo, 00
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 1 Septic Tank & Pit •
Clothes Washer V Shower 1
Dishwasher Shower Pan _
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory L I Water Heater I l.0
Other Fixtures Water Treating System
MISCELLANEOUS: , 7
❑ 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 authori ( Y to violate the rovisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name i 1 F I oo C,{ Phone Number
Plumbing Company Olt ` ne p Pit/lm fi r nu .�vi ( Office Phone 31 J -3 27 Fax
Co. Address: 9 q 3 7 Soy T( e E Gt J City i a( kriv 1 I e State FL Zip 7.2)57
License Holder (Print): on ,1 , C, l ' ' ( J1 State Cerffication/Registration # C / C /4'272 6 I
Notarized Signature of License Holder r 0 / /I , dot
Sworn and subscribed ► : e = e this day o1: 7IC 20/6
Signature of Notar ' bli _s -'� �_