Permit Plbg 750 Bonita 2011 �' `� *::>,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
0 ;' N ATLANTIC BEACH, FL 32233 tit :J
,.;_ INSPECTION PHONE LINE 247 -5826
44 tnt1
11- 00001728 Date 2/28/11
Application Number
Property Address 750 BONITA RD
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . • • 0
Application desc
REPIPE 7 FIXTURES
Owner
Contractor
ZUBIA, HECTOR DAVID GRAY PLUMBING INC.
750 BONITA ROAD 8850 CORPORATE SQUARE CT.
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216 (904) 744 -7255
Permit PLUMBING PERMIT
Additional desc . 7 FIXTURES REPIPE .00
Permit Fee . . • • 104.00 Plan Check Fee .
Issue Date
Valuation . . . . 0
Expiration Date . . 8/27/11
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 104.00 104.00 .00 .00 .00 .00
Plan Check Total .00 .00
Other Fee Total 4.00 4.00 .00
Grand Total
108.00 108.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Mar 08 10 12:54p Information SystemsCITY 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 (904) 247 -5845
JOB ADDRESS: / jO r'�e//Z L v 41 PERMIT # 7// l
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE Qn'
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Slop Sink
Floor mg Fountain n 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
-PIP
F P
TYPE OF FIXTURE QT'S'
TYPE OF FCXTURE QTY
Bathtub / Septic Tank & Pit
Clothes Washer / Shower
Dishwasher _� Shower Pan
Stop Sink
F l oo r Dram Fountain Three Compartment Sink
Floor Sink Toilet /
Hose Bibs / _ Urinal
Kitchen Sink / Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory / Water Heater 1 _.—
Other Fixtures Water Treating System
NHS CELLANEOUS:
❑ 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 final inspection. **
❑ Other - • —
nit 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 pciwit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
P„ 1� � Z & i (,, Phone Number yq '( -- ?3, C
Property Owners Name �. � , o ,.
Plumbing Cornpany David ' ';. Fix if g , inc. Office Phone • i 7.
. Fax 7 » J( f
8851 Urpo rate Square Court
Co. Address: , 22�,� City State Zip
License Holder (Print): RA/fp ) &fee State Certification/Registration # ef 07-1-3
Notarized Signature of License Holder A 01.440 1 1. A
Sworn and subscribed before Inc this$ ay of rY ' u • 20 I
Signature of
Notary Pubic / / .�_
;4, is State of Fl orida i . 1 Neal R Major My Commission EE032510
or to Expires 12/20/2014
6 - 16L-1 , 1 I2 1