Permit Plbg #133 900 Plaza 2011 °r$ 1 ,L�1s fr4
..x ,k�`I‘ CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
�e =�' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
'e'...:1 J131) ;.
Application Number 11- 00002361 Date 7/19/11
Property Address 900 PLAZA 133
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
1 shower pan
Owner Contractor
DAVID GRAY PLUMBING INC.
8850 CORPORATE SQUARE CT.
JACKSONVILLE FL 32216
(904) 744 -7255
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 62.00 Plan Check Fee .00
Issue Date Valuation . . . . 0
Expiration Date . . 1/15/12
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.
Mar 08 10 12:54p information SystemsCJTY 0
904 -247-345 0.1
PLUMBDTG PERMIT APPLICATION
CrrY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5825 Fax (904) 247 -5845
SOB ADDRESS: 7'&0 / 7 Z -- /2r -7 - 7 PERMIT g
NEW OR PLACEMENT INSTAI.I,ATION: Project Value Q /5�& •
TYPE OFFJXTU,i QTY TYPE OF "FIXTURE QrY
Bathtub Septic Tank & Pit
Clothes Washer Shower
•Dishwasher Shower Pan _ —
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs lie gal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other'Fixtures Water Treating System
PE- PIPE;
TYPE OF FiXTURE Q rY TYPE PE OF FperzTRE 077
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Dram
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
L.SCEL.LANNiEOUS:
Se wer Replacement ❑ Back Flow Presenter ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of piin?"g)
❑ Lawn Sprinkler System-Number oz Heads ❑ W **
'` &JRW?TD Well Completion Form. Completed foinz to be submitted to the Building Depart Tent for final inspection.**
❑ Other
'.f 11R1 W1Sr' r- nlg' -m'.4` 4- .i4an. •.N }.•'dwi. ?..ram..•• :: n..wn.:rn 4 -. �Y!tn:•."#r4 5 .. .�:f - �V
'.i � ...x. e_ »ri:.4` •. ...Ni .. .Sf..^er :t: _a .':Y.hYw.:..:t ..CiT4tA}1 =. i'— Sl„lnz�.'r �...ke�.a:
P .nr 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 rear,
tltdE sppiicstion and ionow the same to be true and correct. All provisions of laws and ordinances governing this ?murk will be complied with whether per led
or ac;_ The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of constrocton.
Property Owners Name ,� /H,C Xu fi Phone dabber 2 "25 —G `17 �JV
Davito , ; V Pg ,Mb In a., —f > : ,
r 11 ?nailing Company a g;y r Office ?hone 7 i /A-!' Fax ! " *-e :"i
8850 U o r e S Square Court
cc, Arress, City „ � -
hi •� l s Cit State Zip
License Holder 4- -. �, Stye
�' (T'a nt : y 's� r' 6 Certification egistration 4 er v ,-
':/. 'i rz, rize d Signature of License Homer fit.
Sworn and subscribed be ore the this ! Ada of !/,,w 20 1 /
Signature of Notary Public / X42, 4
alle
e 0 313 ,( i Notary Public State of Florida
Neal R Major
,: , i My Commission EE032510
p oi 0 Expires 12/20/2014