Permit Water Heater 1041 Little Cypress Key 2011 . 'w CITY OF ATLANTIC BEACH Mk 17)
_ jr 800 SEMINOLE ROAD
J
r ��.� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002444 Date 8/04/11
Property Address 1041 LITTLE CYPRESS KEY
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
1 fixture
Owner Contractor
LYONS, JAMES L. TRUST DAVID GRAY PLUMBING INC.
8850 CORPORATE SQUARE CT.
ATLANTIC BEACH FL 32233 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 . 1/31/12
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.
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Mar 08 10 12:54p Information SystemsClTY 0 904- 247 -5845 p.1
PLUMBING PERMIT APPLICATION
C111( OF ATLANTIC BEACH
800 Seminole Rd Atlantic Bah, FL 32233
/Ph /( (9904) 247 -5826 Fax (904) 247 -5845
JC s /Z 4 7? ADDRESS: /� l 7 0/ !e 6 S Ay PERMTT r
W OR REPLACEMENT INSTALLATION: Project Value e
TYPE OF FlxTTIRE OTY TYPE OF FrXTu. Or r
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slap Sink
Floor Drain Three Compartment Sink .
Floor Sink Toilet
Hose Bibs Urhaal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater .
'Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FUTURE OTY TYPE OF F TRE 03 7
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Sink
Floor Drain Three Compartment SLR
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fi. arres Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Presenter ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of pba>"e)
❑ - Lawn Sprinkler System uu?ber of Heads ❑ Well * L ,
.ti ` :SJRWD Well Cain tion Form. Completed form to be submitted to the Buil•'a Department for mss? ins. coon. =*
O Other. f L4cir di - ' Y 0 gE #4 ' _ N i -f'�re ., e
F --nit 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
ft is appiication and know the same to be true and carrvct. All provi ions of laws and ordinances governing this work will be complied with whether sped
or nor_ The pe,uiit does - riot give audio Ito violate the provisions of any other state or local law regulation construction or the performance of construction.
x'rag arty Owners Name � e,5 Z CyaI1 s Phone Number Z y ` 3 9
:Plumbing Company avid , rev gtl ��9 , inc. Office Phone ' " J� _ Fa: - ,97
83 1",:Grpri17.ite Souare Court
cc Aritiress: City State Zip
License. Holder (Print): �ds -���
r' /J0 . , 6/e' State Certif cationfRegistration # el- 0 �
;'AL;ta°¢; eti Signature of License Haider
01 1-
Sworn and subs.. ibed before me this - /• ay e f AIA,d
20 t e
Signature of Notary Public
a �`Y� Notary Public S tate 0o3f 2510 Florida
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Neal R Major
- N �r ``oi rto Exp 12/20/2014