Permit Plbg #105 2025 Seminole 2011 F�,ti
f i r 1 4
6 - - �` , CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
, ; INSPECTION PHONE LINE 247 -5814
!
• 01311x
Application Number 11- 00002309 Date 7
Property Address 2025 SEMINOLE RD 105 /07/11
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
12 FIXTURES
Owner
Contractor
HANNA DAVID GRAY PLUMBING INC.
ATLANTIC BEACH FL 32233 8850 CORPORATE SQUARE CT.
JACKSONVILLE FL 32216
(904) 744 -7255
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . . 139.00 Plan Check Fee
Issue Date 00
Expiration Date . . 1/03/12 Valuation 0
Other Fees STATE PLBG DCA SURCHARGE 2.09
STATE PLBG DBPR SURCHARGE 2.09
Fee summary Charged Paid Credited Due
Permit Fee Total 139.00 139.00 .00
Plan Check Total .00 .00
.00 .00 .00
Other Fee Total 4.18 4.18 .00 .00
Grand Total 143.18 143.18 .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 SystemsCJTY 0
904-247-8845 p. 1
PLUMBING PERMIT APPLICATION
crry OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5525 Fax (904) 247 -5845
O ADDRESS: t
�� 0 Se w� rto 1 `c1 * 106"" PIJ�
NErWV OR LACEbENTINSTALLATION: Project Valve $
TYPE OP' F]it`ru 077
Bathtub
Clothes Washer Septic Tam Pit
Dishwasher Shower
Drinking Fountain Sl Si
er Pan
Floor Drain Slop Sink
Floor Dram Three Compartment Sink
Hose Bibs Toilet
Kitchen Sint{ Urinal
Laundry Tray Vacuum Breakers
Lavafir7 Water Connected. Appliances
- Other Fixtures
Water Heater
Water Treating System
.E OF . 'EtTZr?'t.i~. QrY TYPE OF F' Ixry - j
Bathtub Z 077 Clothes Washer Septic Tank & Pit
Dishwasher i Shower
Shower Pan
DrinPdng Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs a Urinal
Kitchen Sink 1 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory . - Water Heater
Other Fixtures Water Treating System t
1Y1 SCEL.LA1VEOUS:
i2, Sewer Replacement ❑ Back Flow Presenter ❑ Grease Interceptor (Trap) gallons
❑ - 1._.a1,- - Fn Sprinkler SystemNurdber oz Heads -� arc 3 leis ®t p;l;
SIR YD Well m retie, Foy g p . Completed toxr to be submitted to the Building ardent for final inspection.**
O Other
7 ; . , , -- :Zi:b=orties void if work does not commenc within a six month period or work is aended or abandoned for s ; : mo nths. I hereoy c xruiv that I have r
.renal ®n.s..
t` is ppiicati on and ]aiow the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether e
cr uer- The permit does not give authority to violate the provisions of any other state or local law regulation �ctir, d
gelation mu or the performance of coz3r�tti;ction,
r ol rty Owners Name i , UL.rN I-(
r■rsalt-f".. Phone Number 5,3 —% 1S - 7
�r
Pltambing Company
���ia `r p�E�@ inc. �. r Office Phon . 7 & 7 : 3 Fa x ,, 7,„ :C - La
_,. � Square Court y ;
cc, Address: _
City
: � State �
License Hoiden (Print): t 496. � 6:091. State Ce
�� �/ rtif.cation/Registration # e ✓- 0 � L
:N� tsriz Signature of License Hear ifir ,r� t •-�
Sworn and subscribed before me this
--"---. day o£ /.�. 201/
Signature of Notary Public /�/ d y l 1
+� Rr y
Notary Public State of Florida
Neat R Major
, ,`• 4 3 , My Commission EE032510
1.4 oi n.o Expires 12/20/2014
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