Permit Plbg 2208 Fairway Villas 2011 6 ` � , CITY OF ATLANTIC BEACH
� 9 800 SEMINOLE ROAD
t) ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001781 Date 3/09/11
Property Address 2208 N FAIRWAY VILLAS LN
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
11 fixtures
Owner Contractor
BROWN HEATHER D C.W. WOOD PLUMBING
559 EAST COAST DRIVE 1328 ROMNEY STREET
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211
(904) 744 -6604
Permit PLUMBING PERMIT
Additional desc .
Permit Fee 132.00 Plan Check Fee . . .00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 9/05/11
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 132.00 132.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 136.00 136.00 .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- , 5 J 826 Fax (904) 247 -5845
JOB ADDRESS: 7 Z 2 l a d �"W a7 v' / / ` , .f Or- PERMIT #
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NEW OR(6 LACEMEhi INSTALLATION: Project Value $ 30
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Ja Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet `gP
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory a. Water Heater +-
Other Fixtures j' __;__ Water Treating System
RE -PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 2 Septic Tank & Pit
Clothes Washer / Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 2 .
Hose Bibs 2 - Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory ? Water Heater /
Other Fixtures Water Treating System
MISCELLANEOUS: 1 I
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑Lawn Sprinkler System - Number of Heads
❑ Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. *
❑ 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 fo
ons
Property Owners Name /91A5-7, � / /3r0(47/7 Phone Number
Plumbing Company C G✓ GAR v t� Pk nq d. Office Phone 7 `7 - "'"/ Fax 7 y / 7) v
Co. Address: )31.f /3 o m'e S i . City .) aX State%C Zip 3 2 Z '"
License Holder (Print): 6'‘)A. / � Ga' � ' ° 0 - State Certification/Registration # 6 " C 057097
•
Notarized Signature of License Holder s :
- -- — "-''! -�
yP n, ��
...•:� SHIRLEY� s5 GRAfiAti+ 1 404 � 20 jl
Sworn and sub • y i t I ; ';, 4 efl3 les n. 0 ■4I • f
EXPIRES February 14, 2�'��� dial"
y . ned Thru Notary Public U - rwrlters
Signature of N - - = od •