Permit 1860 N Sherry Dr 2011 Plumb CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00001510 Date 1/04/11
Property Address . . . . . . 1860 N SHERRY DR
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 14617
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Application desc
REMODEL MASTER BATH
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Owner Contractor
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BANKS, RICHARD CHAPPELL CONSTRUCTION INC
1860 NORTH SHERRY DR. P 0 BOX 51112
ATLANTIC BEACH FL 32233 JAX BEACH FL 32240
(904) 254-9722
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Sub Contractor . . PREFERRED PLUMBING OF NORTH FL
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 7/03/11
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
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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-./ 14 e e-e!� b tz- PERMIT# 1'5�1
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 0 Back Flow Preventer o Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
* Lawn Sprinkler System-Number of Heads El Well
**SJRWD Well Completion Form. Completed fonn to be submitted to the Building Department for final inspection."
El 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 Phone Number
Plumbing Company tz-C-6 -P J U Office Phone I - 3 ?31 ax 7 S-1-6660
Co. Address: 2 3' !�O- \,j ,J AV-e- city -T'�q X State4l Zip 37Z 21
License Holder(Print): M I�e_ e411A le- State Certification/Registration# C-t-e_ Cr,1-�I
Notarized Signature of License 1161der —
Sworn and subscribed be et s 20_�J
RLEY
Signature of Notary Publi z mi
1 1.� " V1VM&.Tqbr!u�ary�14,2014
Ot*Y Public UndeWb,
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