Permit 1973 Seminole Rd REPIPE 2011 s SSS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
�4.
Application Number . . . . . 11-00001635 Date 2/04/11
Property Address . . . . . . 1973 SEMINOLE RD
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
REPIPE
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Owner Contractor
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REEVE JAMES & EILEEN DAVID GRAY PLUMBING INC.
1973 SEMINOLE ROAD 8850 CORPORATE SQUARE CT.
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
(904) 744-7255
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Permit . . . . . . PLUMBING PERMIT
Additional desc . . 10 FIXTURES - REPIPE
Permit Fee . . . . 125 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/03/11
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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 125 . 00 125 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 129 . 00 129 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Feb 03 11 12:16p DAVID GRAY PLUMBING 904 723 5668 p.1
Y..ar 08 10 12:54o Irformation System OrTY 0 9C4-247-ES46 P.1
PLU1VOING PERIL IYT APPLICATION
CrrY OF ATLAIMC REACH
800 Seminole Rd atlantic Beach FL 32233
Ph(904)247-5826 Fax(904)247-5845/ �Q
:Toil ADDRESS: J le, ,� � PERMLE
NEW OR REPLACEINIEN'T INSTALLATION: Project Vulue S
TYPE of Foo-mw QTY TYPE OF FYXTu" Qi"r
Batbtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher _ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose'Bibs Urinal
Kitc_en Sink Vacuum Breakers
Laundry Tray Water Connected Appliar_ccs
Lavatcfy Water Heater
'Other Fixutes Water Treating System
RIE-PIPE:
—,TYPE a.F Fffruj E Q; TYPE OF Fixt7,-.1ZE Q rr
'Bathtub Septic Tank&?it
Clothes Washer .7 Shower
Dishwasher Shower Pan „
I)rirtldp Fotu7tah: Slop Sink
Floor Drain Three Compamneut Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink VactrumBreakers
Laundry Tray Water Counecied Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
S:
C S..yYer Replacement o Bark FloNv Prewenter ❑ Grease Interceptor(Trap) gallons(Requires 3 ae s of
C i wvn Sprinkler Sjystem Nuar ber o�Heads CO Well
"* SJRFYD Well Compietion Forme.Completed fezm to be submitted to the Building Department for final insgectior1,*1'
o Cher
tmit 3ecotxs void if work Drees not corn,-nenee within a six montft xriod or work is sasp=ded or abwndonrd for six moms. read
rh.s:plication and know the same.c be w=and carts=. All provisions ofkws and ordinances governing this wcrk will be:*=Bed wrto whettler speci,7M1
J.tilt. The pc-,='t pees rot give authority--o viciau the provisions of any other state or local iaw regulation const±uct<on or the performance of con-s-m]Crica.
Property Owners NameC ='2P� ',�e�l� Phone Number 9 Y—
!" bingCompany FJ. a`J ' Gr-!�,,.i Piumbing, 9140. Office Phone �� FaxGI
:3l�t ijt't'f i+iie square :,Our¢ ��—��'
Co. Address: f _ - -. t, _ City State Zip
License Colder(Print): i0 (Z � State Certification/Registraticn 4 C eZ 0Z2y 0E
h
lVatarized Signature of License Bolder I
Swim and subscribed before me this day o(�,4464Z 20
Signature o:Notary Public
r
Nota=1�2,70,20
lda
Nee
My C0
Exp
Mar 08 10 12:54p Information SystemsClT`( 0 904-247-5845 p,1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax(4004)247-5845
T-7
JoB ADDRESS: / /1?�� �i1
9� PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value 5
TYPE oFFvavRE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pam
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 FIXI-b-PE QFY TYPE OF FLYTITRE QTY
Bathtub f Septic Tank&Pit
Clothes Washer �— Shower _
Dishwasher Shower Pan
Drinking Fountain Stop 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 ❑ Back Flow Presenter ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lalkm Sprinkler System Number of Heads ❑ Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other. .
Yannit 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 7a
ti's 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 rot- The permit does not give authority to violate the pro visions of any other state or local law regulation construction or the performance of construction.
Property Owners Naive I IP �j',PPl.�2, Phone Number__$ 7
P1 fav ;zv Plumbing, Inc. ��'
".uniting Company Office Phone 7 7x �� ;26d?Fax �r C�
��k• v, � sE� "ouar Court
Co. Address: ,_ ,�,�� . City State Zip
,"License Holder(Print): ���J� Y� �rl�a�Y State Certification/Registration# G�v C)22���
Notarized Signature of License Holder
Sworn and subscribed before me this day of 20_11
Signature of Notary Public
jVVJ,W A—f
=State
o,►FY"W, e of FloridaE032510E