Permit Plbg to Sewer 1745 Beach 2011 I ` a
° , , A CITY OF ATLANTIC BEACH
'' . , 800 SEMINOLE ROAD
3 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
` 0 1319 . '
Application Number 11- 00002130 Date 6/15/11
Property Address 1745 BEACH AVE
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
CONNECT TO CITY SEWER
Owner Contractor
EAKIN, PAUL METRO ROOTER
1745 BEACH AVENUE 8892 NORMANDY BLVD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32221
(904) 695 -1911
Permit PLUMBING PERMIT
Additional desc . CONNECT TO CITY SEWER
Permit Fee . . . 62.00 Plan Check Fee . . .00
Issue Date . . . 5/24/11 Valuation . . . . 0
Expiration Date . 11/20/11
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.
0 CITY OF ATLANTIC BEACH
IA APPLICATION FOR PLUMBING PERMIT
`'' 800 Seminole Road
Atlantic Beach, Florida 32233
.0i1 t) (904) 247 -5800
Job Location:
/7,/L
Owner of Property: Telephone:
Plumbing Contractor:
Contractor Address:
State License Number: C7-- C. 0 2- 7 Q 'L Telephone:
How many of the following fixtures: ❑ New or ❑ Re -Piped
SINKS SHOWERS
LAVATORY WATER HEATERS
BATH TUBS DISHWASHERS
URINALS DISPOSALS
CLOSETS WASHING MACHINE
FLOOR DRAINS SHOWER PANS
SEWER WATER
t
RE -PIPE (LIST FIXTURES BEING REPIPED) I
OTHER - 1
1
Minimum Permit Fee: $35.00
Total Fixtures: X $7.00 + $35.00 =
Signature of Owner: ,
Signature of Contractor: :.�►
Installation of plumbing an' • ures must be in accordance with the most recent edition of the
Southern Standard Plumb' _ ' ode.
Call a day ahead to schedule inspections: (904) 247 -5826
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: / / 7`� /3 ivie PERMIT # /
NEW OR REPLACEMENT INSTALLATION: Project Value $ " OA:0
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 submitted to the Building Department for final inspection. **
Other . & / 0'/") C 7 5e . /e L-cP/v "t,($ Ie2/I/
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 / , k / e✓ Phone Number gyg.- bJre-
Plumbing Company f?c/ %4 M 9 / .. jl/ Office Phone ,'27591 ." Fax2/ V 79
Co. Address: I'9 7 / , ' f ) * L 27f'. /V City �f� � State FL Zip 321 - — 6
License Holder (Print): "7241: / ` State Certification/Registration # 4 /¢ Z'7
Notarized Signatur' !. _ - - j r .,,11: ` -
'
k - „
R A H ..kw ,
le P�RES,May . ,,d rn and subsc 'bed before m hi d. o 20 `
- -. htu Notary Public , /
� , ; �' a°" Signature of Notary Public
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