Permit Plbg 631 Beach 2011 4 t om 1 - W ;r
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•, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
t..). ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001809 Date 4/11/11
Property Address 631 BEACH AVE
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 125000
Application desc
renovations to carriage house
Owner Contractor
HUGHES SATILLA INC
631 BEACH AVENUE 2742 HERSCHEL STREET
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32205
(904) 389 -3704
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 97.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/08/11
Special Notes and Comments
Avoid damage to underground water /sewer utilities. Verify
vertical and horizontal location of utilities. Hand dig if
necessary. If field coordination is needed, call 247 -5834.
Ensure all meter boxes, sewer cleanouts and valve covers
are set to grade and visible.
Roll off container company must be on City approved list
and container cannot be placed on City right -of -way.
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST
CONTROL COMPANY PRIOR TO C.O.
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
PERMIT IS �i� LAB (icA9 E Q DANCE 'ALP @ITY OF ATLJV ORDINANCEQ (AND THE FLORIDA° 0
BUILDING CODES.
4SA CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
: D33191
Page 2
Application Number . . . . . 11- 00001809 Date 4/11/11
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 101.00 101.00 .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 -5826 Fax (904) 247 -5845
JOB ADDRESS: (03 1 ZU el. kk. O '— PERMIT # / 1 — r e
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer _i___ Shower 1
Dishwasher ____L_ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet _
Hose Bibs Urinal
Kitchen Sink 6 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 1 Water Heater
Other Fixtures Water Treating System
RE -PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
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 Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ 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 of construction.
Property Owners Name Phone Number
Plumbing Company R- -c -' L, w..Lii,_. d-t-s Office Phone a a '3 SR --- Fax 2 z a —r7671)
Co. Address: (9 a-3 a-- ci_e,. e c�ra +c s,_,..,, NA___ �c..c�As�,..,( I lc State F� Zip 3 - 2.2C L
License Holder (Print): l9PU�E e. t �v " State Certification/Registration #
Notarized Sisrz!ature of License Holder 4 , , , r
Pu Notary Public State of Florida Sworn and subscribed before .iii this day of / / 20 11
: ° �� Lori S Nordgren
N� My Commission DD766611 Signature of Notary Public / ' ` 4, • / /
v or, a Expires 03/10/2012
4