Permit Plbg 1941 1943 Beach 2011 �%u1 r
; 6, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002006 Date 4/28/11
Property Address 1941 43 BEACH AVE 1943
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . 0
Application desc
Connect to Sanitary Sewer (2) 1941 and 1943
Owner Contractor
MORGAN, WILLIAM C.W. WOOD PLUMBING
220 EAST FORSYTH 1328 ROMNEY STREET
JACKSONVILLE FL 32202 JACKSONVILLE FL 32211
(904) 744 -6604
Permit PLUMBING PERMIT
Additional desc . 2 SEWER CONN. 1941 AND 1943
Permit Fee . . . 69.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/25/11
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 69.00 69.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 73.00 73.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
5
CITY OF ATLANTIC BEACH /7., 04
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: / g l / G 4/3 /3e,(44 ,dve ' PERMIT # / 7
NEW OR REPLACEMENT INSTALLATION: Project Value $
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
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 su miffed to the Building Dep , ent for final inspection. **
l
El Other % ) d:9 -c Z (2 J : ,./ 4. . e_
AO
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 4 , 1 - ""� s - /%j 0_, Phone Number
Plumbing Company ' . 6n) . 1 1/ao / Phi "1i,; -,s Office Phone 7'V 6‘ Fax 75'3 -/ 730
Co. Address: /3 ZS? A v 2 S ✓ .. City J u-X State J� Zip3 z-Z 1/
License Holder (Print): vV. c.r` State Certification/Registration # G�� )57 - 77
Notarized Signatu • 1 • • • • : •_.. _, vv "4, `Y,
DEBORAH A. WHITE
�' �` ' o C d ay o tor,'
2
and subscribed before e 's
,.. t MY COMMISSION # D 6
t" , : , EXPIRES: May 21 201 Wire
.•' c o� 'ors / fj'
'' Bonded Thru Notary Public Unde
" ' �R f , e h•• ` - ure of Notary Public , - � � -
.5 a (c276 . cf6
0 ` ,, :` CITY OF ATLANTIC BEACH
;, 800 SEMINOLE ROAD
s ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
k .
Application Number 11- 00000490 Date 4/28/11
Property Address 1941 43 BEACH AVE 1943
Application type description SYSTEM DEVELOPMENT CHARGE RESIDENTIAL (S
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
System charge for 2 taps 1941 and 1943
Owner Contractor
MORGAN, WILLIAM OWNER
220 EAST FORSYTH
JACKSONVILLE FL 32202
Permit SYSTEM DEVELOPMENT CHARGE RES
Additional desc . SYSTEM DEV CHG 1941 AND 1943
Permit Fee 8100.00 Plan Check Fee . . .00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 4/28/11
Fee summary Charged Paid Credited Due
Permit Fee Total 8100.00 8100.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 8100.00 8100.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.