Permit Plbg Shower pan 2215 Alicia 2011 :. rF, CITY OF ATLANTIC BEACH
ir. , s)
800 SEMINOLE ROAD
J��. �" ATLANTIC BEACH, FL 32233
.,4%, INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002629 Date 9/16/11
Property Address 2215 ALICIA LN / /11
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
1 shower pan
Owner Contractor
LEWIS DENISE KLETT LIVING TRST TROY TRAWICK PLUMBING CO, INC
335 W 107TH STREET 6228 LOTTIE ST
CARMEL IN 460329587 JACKSONVILLE FL 32216
(904) 721 -8400
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 62.00 Plan Check Fee .00
Issue Date Valuation . . . . 0
Expiration Date . . 3/14/12
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.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: 2 Z I 5 .4 1r t`c L h e _ PERMIT # // - r�va
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 Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Lawn Sprinkler System - Number of Heads ❑ 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 to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name Phone Number
Plumbing Company fRogRitutt K / /c4-76/ ;-:6_ (G, Office Phone 72/ Fax 72 /
Co. Address: .2 970 err leZi'JJ4, ?C F(
22 City ,- eli K State FL Zip 3 2 2 qlo
License Holder (Print): 1: "/—i c " ' State Ce 'fication/Registration # CfC /Y26097
Notarized Signature of License Holder r.'"---------------'
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--- � lP da o ��L., r 20/1
"�, bscribed before '
SHIRLEYL.
MY COMMISSION it DD 957760
EXPIRES: FebrU
dire +f Notary Public onded T hru No tary Public nderwniters .4 e ' , •
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