Permit Plbg 1426 Ocean 2011 dyej
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4 ' ' CITY OF ATLANTIC BEACH
1 # ' 800 SEMINOLE ROAD
J � " = ATLANTIC BEACH, FL 32233
�� INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001930 Date 4/13/11
Property Address 1426 OCEAN BLVD
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
10 fixtures
Owner Contractor
JOSEPH, II, W.L. STEEG PLUMBING
1426 OCEAN BLVD. 1601 MAIN STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 249 -5191
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 125.00 Plan Check Fee .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10 /10 /11
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 125.00 125.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 129.00 129.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: /
/ L4 2 G =C,..„ / PERMIT #
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 / Water Heater
Other Fixtures Water Treating System
RE -PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub / Septic Tank & Pit
Clothes Washer i Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 7-
Hose Bibs _ 2 Urinal
Kitchen Sink / Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory / Water Heater
Other Fixtures Water Treating System 1-/
• MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires sets of plan
❑ 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 ra
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 local law regulation construction or the performance of construction
Property Owners Name /�o) S7r 4 Phone Number
Plumbing Company $ /43 e IC Office Phone 0 / g•5/9/ Fax ti
Co. Address: /4P) ,4'L t City ,d% ,' 4 State,/ Zip , FZ x 3 3
License Holder (Print): 4- / N1 '5/°..3 State Certification/Registration # e -3214
Notarized Signature oi`License Holder .
" ' ? sc ' � '. J w . ., a a of 20 _
Sworn
_ -� � t ti: gS' F 14, 2014
' Bonded T . N.. %.Public Underwrite I J � r
S ignat' 3'. ,.�,.,�..,:,�- .ii a
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