Permit Plbg 168 Sylvan 2011 j 1,,,
rY 41
t` A CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
6t�3.19
Application Number 11- 00001675 Date 3/28/11
Property Address 168 SYLVAN DR
Application type description RESIDENTIAL OTHER
Property Zoning TO BE UPDATED
Application valuation . . . 800
Application desc
repair rotten wood
Owner Contractor
GASTON, LOIS OWNER
168 SYLVAN DRIVE
ATLANTIC BEACH FL 32233
Permit PLUMBING PERMIT
Additional desc .
Sub Contractor . DAVID GRAY PLUMBING INC.
Permit Fee . . . 76.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 9/24/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 76.00 76.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 80.00 80.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Mar 28 11 09:22a DAVID GRAY PLUMBING 904 723 5668 p.1
Mar C8 10 12:54p Information SysternsCITY 0 904 - 247 - 5845 D.1
PLU_'VIBING PEST APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 d . / lg 1 5
Ph (904) 247 -5826 Fax (904) 247 -5845 1 1
:TDB ADDRESS: I ( � i ' L� �a Iv L, r7 a 1 PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value $ •
TYPE OF FIXTURE Q t rr TYPE OF FJxTURE QTY
3athtub l Septic Tank & Pit
Clothes Washer Shower
Dishwasher -Shower Pao
g o Sky Sink
Floor Drain Three Compartment Sink ,"
Floor Sink Toilet -
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry T Water Connected Appliances
Lays.to7 __1- -- Water Heater _ .
Other Fixtures Water Treating System
-
RE -PIPE:
TYPE OF FMIME Qrx TrrE oo FZXrURE QrY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
S[ Sink
Flo Drain uatam Thee Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sic. Vacuum. Breakers
Laundry Tray- Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS :
D Sewer Replacement ❑ Back Flow Preventer 0 Grease Interceptor (Trap) gallons (Requires 3 sets of ply)
C taw) Sprinkler System- Nuniber of Heads ❑ Well **
" &IRWD Well Compie. ion Form. Completed form to be submitted to the Building Department for fined inspection.*''
CiOther ..,?L L� f
(` f/ rii.i ,. -
P,; .nit become=_ void if work does not commence within a six month period or work is suspended or abandoned for six niontbs. I Hereby certify that 1 have rear
; is a✓plicazion and know the same to be 'rue and correct, All provisions of laws and ordinances governing this work will be complied with whether specified
or x:ct The pent t does net give thorny tri late the p visions of any ether state D7 vocal law regulation construction or the pexfor ante cf construction.
Property Owners Name -le 6 1,1 . phone Number -' 1 t
,
David av Plumbing, Inc. lrf `- 7)=- � °:
P bing Company
Off ice Phone Fax "
e850 i ;.; ,C(;!'; 'care Court
Cc. Address: , _ ,. _ City State Zip
License Holder (Print): ,jYgvip :::), 01 "y la u State Cert fication/Re gistration i* e plr t� `2S 3E
Notarized Signature of License Holder 1 )14417 u/ 1
Sworn and subscribed before me this � d o f a" 20 a
Signature of Notary Public ) �r/L
? e 0 otary Public State of Florida
Neal Ft Maim : ` - d�tte.g,nrisaion'€F032510
''t . Expires 11 • '
i.,