Permit Sewer Repl 99 Saratoga 2011 4 i� !'
,� er ,`j s CITY OF ATLANTIC BEACH
' � - , ° " ) 800 SEMINOLE ROAD
J ,,,- ,. ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002197 Date 6/13/11
Property Address 99 S SARATOGA CIR
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . 0
Application desc
sewer replacement
Owner Contractor
SCHEIDERER, FRED ROTO ROOTER SERVICES
99 SARATOGA 2028 W 21ST ST
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 354 -7321
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 62.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 12/10/11
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 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.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: 99 S ( Ri4 + ov* C l iZ PERMIT #
■1EW OR REPLACEMENT INSTALLATION: Project Value $
P.p00
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
Other Fixtures Water Heater
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
SSCELLANEOUS:
ewer 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
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
:his 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
Dr 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 b A kF �.l HA RS LL'' MI M7 _ 6.5" 9,
T Phone Number
Plumbing Company p,01(7 �t9 Eik 50 C. C C7 . Office Phone 33'`1- ?3 Fax3C /- 925..5"
Co. Address: Ab a 9 e 02 1 s+ S I re42c -- City ZrAcKSp State e'( Zip '
P 32 2.v
License Holder (Print): R. 34-- V , PA-2 liz State Certifi tion/Registration # C FG v 'H !3
Notarized Signature of License Holder 4-1/`
1
`4'pyk.Swo ylibed.;•efore n '
f:( .': MY COMMISSION # DD 957760 0 of
^ R'g `Aga gi # ' k,' blic _ .r