Permit Plbg #94 1088 Cornell 2011 ICI
� , ` l CITY OF ATLANTIC BEACH
' s') 800 SEMINOLE ROAD
j
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001589 Date 1/24/11
Property Address 1088 UNIT 94 CORNELL LN
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
1 fixture
Owner Contractor
CHRIS HULME PLBG, INC
55010 YELLOW JACKET RD
CALLAHAN FL 32011
(904) 879 -5095
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 62.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 7/23/11
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)) -5845
JOB ADDRESS:
0 g CO0'/1 a Lane — Ot // i�/r C PERMIT # << . ,
Pedal 1 '22 3 — U r\ki- A citt-
NEW OR REPLACEMENT INSTALLATION: Project Value $ $o 0
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 L
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers l
Laundry Tray Water Connected Appliances
Lavatory Water Heater i `" _I
Other Fixtures Water Treating System ' )
•
RE -PIPE:
,
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
S.
Bathtub Septic Tank & Pit
Clothes Washer Shower \ `
Dishwasher Shower Pan '�`�;
Drinking Fountain Slop ink
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 **
** SIRWD Well Completion Form. Completed form to be submitted to the Building Department for fmal 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 /?/y G i, ` &rO p e r1' ys Phone Number 2 - ' - 9 — 75 3-6
pL.�� ,,,,,/,:. 4 p 4--
Plumbing Company 7'' /f. /. 7I.
S/ l z / 7 v Office Phone 8 7 c —5Df ax
C� / C i C.4e . ', State / . ?2c)1(
Co. Address: 5 S?�l U7L`'� e GL,i � City
License Holder (Print): Cle '/ i tor State Certification/Registration # C�`�C G
Notarized Signature of License Holder —
, Sworn and subscribed before m -s 's I s e day of � C JCkrv, 201 1
, _ . ERIN E. MILLIGAN
' A ' Notary Public, State of Florida tilt of Notary Public :11 1 1 - ` t. ` 1.11
"-'; Commission #DD885550 rl�'
uw 1 \ \s, �Q .
My Comm. expires Apr. 30, 2013 ! �.J