Permit Plbg #121 900 Plaza 2011 CITY OF ATLANTIC BEACH
j
f j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
, INSPECTION PHONE LINE 247 -5814
4 011,19`'
Application Number 11- 00002005 Date 4/29/11
Property Address 900 PLAZA
Tenant nbr, name UNIT 121
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . 0
Application desc
1 fixture
Owner Contractor
SEA OATS LIMITED PARTNERSHIP DAVID GRAY PLUMBING INC.
900 PLAZA 8850 CORPORATE SQUARE CT.
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
(904) 744 -7255
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 62.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/26/11
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 62.00 62.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 66.00 66.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Mar 08 10 12:54p information SystemsClrY 0 904- 247 -5845 p.1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: (/ ?/a. Z' l:C . i/ t . # 1 / PERMIT #
NEW OR ' LACEMENT INSTALLAT I N7 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 Fixrui E 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
YEISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Presenter ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Lawn Sprinkler System Number ofHeads ❑ Well **
** SJRWD Well Completion Form. Completed foam to be submitted to the Building Department for final inspection. **
C 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 specited
or not. The permit does not give authority to violate tl}e provisions of any other to or local law regulation construction or the performance of construction.
Property Owners Name ��, ( ? et `Z let D/? Phone Number *" "KU
David Gray Plumbing, inc. Office Phone
�`i aunbing Company 72.-.CS- Fax 7X3° g
8850 s o, , Square Court
Co. Address: City State
Zip
License Holder (Print): ,P° (ip ) tcii1=�Y State Certification/Registration # ePik O'L2 . s'
oc rdzed Signature of License Holder j'� 1 •/ /
Sworn and subscribed before me this 2 day of , J `, 20)1 .
Signature of Notary Public i /i i i '
= o. 'u N otary - u• is - • • - , , , 0. Neal R Major EE032510
•
c A` My Commission
�„
''1 O f tv o' Expires 12/20/2014