Permit Plbg 1748 Ocean Grove 2011 ' ' S CITY OF ATLANTIC BEACH
,' °' ) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
- 1 ' . 4,01 . 0'1 4
Application Number 11- 00001849 Date 3/29/11
Property Address 1748 OCEAN GROVE DR
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
12 fixtures
Owner Contractor
MATREGRANO STEEG PLUMBING
1748 OCEAN GROVE DR. 1601 MAIN STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 249 -5191
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 139.00 Plan Check Fee .00
Issue Date Valuation . . . . 0
Expiration Date . . 9/25/11
Other Fees STATE PLBG DCA SURCHARGE 2.09
STATE PLBG DBPR SURCHARGE 2.09
Fee summary Charged Paid Credited Due
Permit Fee Total 139.00 139.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.18 4.18 .00 .00
Grand Total 143.18 143.18 .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
JOB ADDRESS: l 7 J 2 C-t1'1 e y-L SI PER T # / /' /d 7 g
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE OTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
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
Other Fixtures Water Heater ,
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
Hose Bibs
Kitchen Sink --1 Urinal
/ Vacuum Breakers
Laundry Tray
Lavatory Water Connected Appliances
Other Fixtures Water Heater /
Water Treating System
qy •
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons
(Requires 3 sets of plan
❑ Lawn Sprinkler System - Number of Heads ❑ Well **
x* 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 rc
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 specific
or not. The permit does not give authority to violate the provisions of any other state or Iocal law regulation construction or the performance of construction
Property Owners Name /3 j/ Z 94,,1 f y Phone Number
Plumbing Company . 5 . /& - e5, / /,bf C0 s^ Office Phone Z99 /y/ Faxt e//-07
Co. Address: flppj 4 57- City At- leA State / zip3ZZ33
License Holder (Print): J( 5 r-5 State Certification /Registration #O R0. 3'7"
Notarized Signature o Lic f ° '� , ; . "u' ' eA s � 4� 4 r i
r
—44 ES r qua. 14a 4 �/1� C �(/
G - ' "$ °' � , 7 l • - " me ti s 1 � day • f it � tl l
Signature of Notary Put. 40 41 • G ,
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