Permit Plbg 447 Selva Lks 2011 61 w i ss CITY OF ATLANTIC BEACH
i 800 SEMINOLE ROAD
-,. ATLANTIC BEACH, FL 32233
t � INSPECTION PHONE LINE 247 -5826
,. -
-. J t l 9
Application Number 11- 00001678 Date 2/14/11
Property Address 447 SELVA LAKES CIR
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
13 fixtures
Owner Contractor
MILLER, TOMMY STEEG PLUMBING
447 SELVA LAKES CIRCLE 1601 MAIN STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 249 -5191
Permit PLUMBING PERMIT
Additional desc . .00
Permit Fee . . . 146.00 Plan Check Fee . .
Issue Date . . . Valuation . . . . 0
Expiration Date . 8/13/11
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 146.00 146.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 150.00 150.00 .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 ' ' 1 JOB ADDRESS: _
44 r_._ i ,e--, PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value
TYPE OF FIXTURE QTY
TYPE OF FIXTURE OTY
Septic Tank & Pit
Bathtub • Shower
Clothes Washer Shower Pan Dishwasher Slop Sink
Drinking Fountain Three Compartment Sink
Floor Drain Toilet
Floor Sink Urinal —
Hose Bibs Vacuum Breakers
Kitchen Sink Water Connected Appliances
Laundry Tray Water Heater
Lavatory Water Treating System
Other Fixtures
RE -PIPE: QTY
TYPE OF FIXTURE
TYPE OF FIXTURE Qom' Septic Tank & Pit
Bathtub /
Clothes Washer / Shower Pan
Dishwasher Slop Sink
Floor r Drinking Fountain Three Compartment Sink
Floor Drain Toilet n
Floor Sink Urinal 1
Hose Bibs --/-- Vacuum Breakers
Kitchen Sink Water Connected Appliances ___
Laundry Tray Water Heater
Lavatory Water Treating System
Other Fixtures _ , .
•
MISCELLANEOUS: g gallons (Requires 3 sets of plan
f
❑ Sewer Replacement ❑Back Flow Preventer ❑ GTeaSe Interceptor ell (Trap) **
Ell Lawn Sprinkler System Number of Heads — De artrnent for final inspection."
** S'JRWD Well Completion Form. Completed form to be submitted to the Bui g P
❑ Other
certify that Y have n c es void if work does not commence within a six month period or work is suspended or abandoned for
ork will be .1 hereby certify 1 that �
Permp becomes koon or the performance of construction
this a and know the same to be true and correct. All provisions of laws and ordinances governing
or not. The permit does not give authority to violate the provisions of any other state or local law regulation constru
t- - r (X X,/ Phone Number
Property Owners Name L/ � � Co Ti- r - Fax r�
Office Phone
Plumbing Company l City S tate f Z ip 22.J
Co. Address: �'�) �� /�' 0 � -
`IT State Certificationaegistra
License Bolder (Print): __
4 "" e � t- GRAHAM T /I 1, , /'tom" O
Notarized Signature f , .v MYCOMMISSIO` X1957780 "' g � � �, of i/
� ,80 R
, ' Bonded � u� ,� j v - fore m I's
P,f� yondedThr �' i'• , :
Signature of Notary Pub ' - -� i - ��