Permit Plbg Repipe 410 S Oceanwalk 2011 ,Lys lei
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CITY OF ATLANTIC BEACH
� , ' , ) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
4 INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002360 Date 7
Property Address 410 S OCEANWALK DR /19/11
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
repipe 19 fixtures
Owner Contractor
PODZAMSKY, SUSAN ATLANTIC COAST PLUMBING CORP.
410 OCEANWALK DRIVE S. 3653 REGENT BLVD #305
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224
(904) 249 -5381
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 188.00 Plan Check Fee .
Issue Date .00
Valuation 0
Expiration Date . . 1/15/12
Other Fees STATE PLBG DCA SURCHARGE 2.82
STATE PLBG DBPR SURCHARGE 2.82
Fee summary Charged Paid Credited Due
Permit Fee Total 188.00 188.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 5.64 5.64 .00 .00
Grand Total 193.64 193.64 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Ju1 19 11 10:47a Susan Parrish
904 -246 -3673 p.1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800.Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -58 > 26 Fax (904) 247 -5845
JOB ADDRESS: r�0 !�4 4 '>J-, LC0
PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value $
TITE OF FDatrRE QTp rpm OF.FixruR&
Bathtub QTY
Clothes Washer Septic Tank Pit
Dishwasher Shower �-----
Drinking Fountain Shower Pan
Floor Drain Slop Sink
Floor Sink Three Compartment Sink
Hose Bibs Toilet
Kitchen Sink Urinal
Laundry Tray Vacuum Breakers
Lavatot Water Connected Appliances
//– Fixttues Water Heater
KN. Water Treating System
RE -PIPE:
,
E OFFLrflJRE QTY TYPE OF FIXTURE
Bathtub 2 QTY
Clothes armo Septic Tank & Pit
Clothes
___L_.... Shower iii
—�-- -
Drinking Fountain
Floor Pan
Floor Drain Slop Sink
Floor Sink Three Compartment Sink
Hose Bibs Z Toilet "
Kitchen Sink Urinal
f
Laundry Tray -- 1 Vacuum C Breakers
_ Water Connected Appliances
Lavatory
Other Fixtures Water Heater y I (h
Water Treating System . /
MISCELLANEOUS:
•
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Tra
❑ Lawn Sprinkler System - Number of Heads p) gallons (Requires 3 sets of plans)
** SJRWD Well Completion Fora,. Completed form to be submitted to the B 'din final $ Department for inspection. * *
0 Other
•
Peruoit becomes void f work does not II eace l """ t a six month
this appficatioa and know the same to be true and correct All provisionsIa s d ordir ces g governing this work will be complied with whether spearieti
or not The permit does not give authority to vie rev
isions of any other state or local taw regulation construction or the performance of construction.
Property Owners Name vie b d, i. Phone Ntun J�Oa
Company } � -,:,?..5-S4:2 -,:,?..5-S4:2 -,:,?..5-S4:2 Plumbing p y �� ,495 �t � 47 Office Phone 5 3.2 Fax ‘5 630
co. Address: _ _ k , �C1 X0 ,
`' " 3 Ci ,9GASt,,idir� State l7 Zip 3
License Bolder (Print): /4/1/ / „
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,4 i r S 1LL AIMS. . -.:._' ,. .,c-�:. for tegistratton # 6Pe 0 0 ." f
Notarized Signature of License Holder .1 1 W
t
Sworn and su • : M 'bed be ore me th' .
Si of No ' '
Notary Public .rL. ' f� :._ N _ Pu • State of Florida
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.z �7 � , ►`� � l Commission d+ p 880918
%,f,, 41., 8ondrd Thump
r, 1 ;.,. , , -, , ... l ug National Notary Asttn.
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