Permit Plbg Repipe 1588 Ocean Blvd 2011 e f' vi r y ,,
6\ Pr' .".;-is‘ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002191 Date 6/09/11
Property Address 1588 OCEAN BLVD
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
10 fixture
Owner Contractor
FUSSELL, JR., R.H. STEEG PLUMBING CO., INC.
1588 OCEAN BLVD. P.O.BOX 330536
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 . 12/06/11
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total l 125.00 125.00 .00 .00
Plan Check Tota .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
806 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 A ax (904) 247 -5845 1/
PERMIT tt q
JOB ADDRESS: '1 o` �j
NEW OR REPLACEMENT INSTALLATION: Project Value
TYPE OF FIXT£T.RE
OTY TYPE OF FIXTURE Off'
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 FUTURE QTY
TYPE OF FIXTURE OTY
Bathtub / Septic Tank & Pit
Clothes Washer / Shower /
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Dram Three Compartment Sink
Floor Sink Toilet
Hose Bibs _2 Urinal
Kitchen Sink / Vacuum Breakers
Laundry Tray Water Connected Appliances /
Lavatory = Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS: gallons (Requires 3 sets of pt:
El Sewer Replacement ❑ Back Flow Preventer o Grease Interceptor (Trap) g
❑ Lawn Sprinkler System Number of Heads ❑ Well **
X SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspectiol
C Other
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
this application becomes
this permit and know the same to authority, e and correct.
the provisions of any other state or local law regulation co or the performance f construed'
or not of The permit does not give author , to
,�- Phone Number
Property Owners Name IJ /js�l� a � �. �� F � �3
�3 c P /�j 2D -Xe Office Phone
Plumbing Company � �?�%
'
j �j�.� State f_/ ZiP�_._ -
/ '4(y- 5 City
Co. Address: � 4�•v3>l9i
License Holder (Print): Of n" 59 ? ‹5 State Certification/Registration
Notarized Signature of License Holder � • . ,4 S_ - � ,• �0. • ' � x � : ,ii day • toy and . • ed" _ • , iLal E.
�. r EXP I
Notary
yalk
... ,.
Signature ,