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Permit 123 Fleet Landing Blvd PLUMB 2011 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 11-00001573 Date 1/20/11 Property Address . . . . . . 123 FLEET LANDING BLVD Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 4 fixtures ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ NAVAL CONTINUING CARE ASHLEY PLUMBING CO INC FLEET LANDING 1738 KINGS AVE 1 FLEET LANDING BOULEVARD JACKSONVILLE FL 32207 ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 83 . 00 Plan Check Fee . 00 Issue Date . . . . valuation . . . . 0 Expiration Date . . 7/19/11 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 83 . 00 83 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 87 . 00 87 . 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: VA+ I Z3 PERMIT# 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 i 4 0-"'fAt-J Water Heater Other Fixtures 2- 1)y VA(t? 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 I rooc Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: (k * Sewer Replacement El Back Flow Preventer Ei Grease Interceptor (Trap) gallons(Requires 3 sets of plans) * Lawn Sprinkler System-Number of Heads 0 Well ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection." o 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 *W4151 PlumbingCompany �qcw3m, P1wjnv\r-\ Office Phone .3q3- Fax M1:0L5 Co. Address: City(TaCV4bVIQIJ(� Statej�, Zip---32�;-2_0_) License Holder(Print). State Certification/Registration# )5zwv Notarized S der A 'a L E ()3 103 01 R BLE SEY It 0 KELSEY R STR VAQ C �is d 20 4 my OMMISSI1 av Of J/ My COMMISSION 0 EE035103 wom and subscribed before me t X S Ocl �2 4 EXPIRES October 17,2014 ignature of Notary Public (10 )=396-0153 -- 1�-