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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 - ��