Permit Plbg 4000 Fleet Landing 2011 ' '` CITY OF ATLANTIC BEACH
^; .01 800 SEMINOLE ROAD
+3 �'` ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002312 Date 7/07/11
Property Address 4000 FLEET LANDING BLVD
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
3 FIXTURES
Owner Contractor
DAVID GRAY PLUMBING INC.
8850 CORPORATE SQUARE CT.
JACKSONVILLE FL 32216
(904) 744 -7255
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 76.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 1/03/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 76.00 76.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 80.00 80.00 .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 SystemsClTY 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
4,e-/
JOB ADDRESS: / ! /��IJ• 124 PERMIT it
•
NEW OR REPLACEMENT INSTALLATION: 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 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 FixtuTes Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Presenter ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Lawn Sprinkler System Number of ❑ 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
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 .1 late the ..visi J. of any.other state or local law regulation construction or the performance of construction.
Property Owners Name J .1 / 'tq f. ''
U� Phone Number - . --
e Gray Plumbing, Inc.
Plumbing Company Office Phone 74/ Fax ':13- -Slvel/
8850 Corporate Square Cuurt —
Co. Address: ) , .. .. : It it ., t City State Zip
License Holder (Print): J17 > 4 State Certification/Registration # Chv 0:
Notarized Signature of License Holder t „, 1 ' _
SIArozTI and subscribed before . - 's _ day of I„ :C7L/
Signature of Notary Public I W"i M'` 1
.'itYA Notary
• � Neal Y is State of Florida
ajar
4 i MY Co mission EE032510
o no' Expires 12/20/2014