Permit Plbg 144 Poinsettia St 2011 z ss' CITY OF ATLANTIC BEACH
A
..i fit Y�
800 SEMINOLE ROAD
` '� ATLANTIC BEACH, FL 32233
c INSPECTION PHONE LINE 247 -5826
Application Number
Property Address 11- 00001884
144 POINSETTIA ST Date 4/06/11
Application type description PLUMBING ONLY
Property Zoning
Application valuation . . . • TO BE UPDATED
Application desc
10 fixtures
Owner
Contractor
HOWARD
144 POINSETTIA STREET STEEG PLUMBING
1601 MAIN STREET
ATLANTIC BEACH
FL 32233 ATLANTIC BEACH
(904) 249 -5191 FL 32233
Permit PLUMBING PERMIT
Additional desc .
Permit Fee 125.00
Issue Date . , Plan Check Fee .00
Valuation . . . 0
Expiration Date
10/03/11
Other Fees STATE PLBG DCA SURCHARGE
STATE PLBG DBPR SURCHARGE 2.00
2.00
Fee summary Charged Paid
Credited Due
Permit Fee Total 125.00
Plan Check Total 125.00 .00 .00
Other Fee Total .00 ' .00
4.00 4.00 .00
Grand Total 129.00 .00 .00
129.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
3 . CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
PERMTT �
JOB ADDRESS: Am
N E W OR REPLACEMENT INSTALLATION: Project Value S �Tr
TYPE OF FIXTURE OTY TYPE OF FIXTURE -
Bathtub Septic Tank & Pit
Shower
Clothes Washer Shower Pan
Dishwasher Slop Sink
Floor r Drinking Fountain Three Compartment Sink
Floor Drain Toilet
Floor Sink Urinal Hose Bibs Vacuum Breakers
Kitchen Sink Water Connected Appliances
Laundry Tray Water Heater
Othh er Fixtures a Water Treating System
O
RE-PIPE: pTy
TYPE OF FIXTURE
TYPE OF ,FIXTURE OTT'
Bathtub Septic Tank & Pit / Shower
Clothes Washer - Shower Pan -
Dishwasher —� Slop Sink
Flo' D Fountain Three Compartment Sink
Floor Drain Toilet ---
Floor Sink Urinal
Hose Bibs --�� Vacuum Breakers
Kitchen Sink Water Connected Appliances
Laundry Tray --- I -- Water Heater
Lavatory
Other Fixtures 1 Water Treating System
•
, .
MISCELLANEOUS: gallons (Requires 3 sets of plan
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap)
❑ Lawn Sprinkler System Number of Heads
❑ Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.'
❑ Other
that I have rl
this work will be complied . I he with certify that
tr have r i
or n
Permit becomes void if work does not commence within a six mono period of la work is ordinances suspended
d ned for six months
governing . I hereby � of construction
this not. The permit and rmit d oes not a same to give autho ri true and correct. ty to violate the pr ov P isions of any other state or local law regulation construction or the performance ot. Te peoes not riov
/ L'P . > ��_ Phone Number
Property Owners Name � � Z; L-4 Fax ill z��r
L-4 Office Phone
Plumbing Company 1 l L State Zip �_
City
Co. Address: / /�' r � � �� 1'74 License Holder (print): �) »`► 9z-z- -
State Certification/Registration #,
Notarized Signature of License Hob., , „ , o N ' 957760 1„ . , �_, 2
I y \ u s _ s ay of y �i , 0 E. * Bonded ru Notary U ,