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Permit Plbg Water Heater #16 1088 Cornell 2011 ( S''' , CITY OF ATLANTIC BEACH 4 F 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 - 5814 �•a ;. t Application Number . . . 11- 00002688 Property Address 1088 CORNELL LN UNIT 16 Date 9/28/11 Application type description PLUMBING ONLY Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc 1 FIXTURE Owner Contractor CHRIS HULME PLBG, INC 55010 YELLOW JACKET RD CALLAHAN FL 32011 (904) 879 -5095 Permit PLUMBING PERMIT Additional desc . Permit Fee . . . 62.00 Plan Check Fee Issue Date . Valuation 00 Expiration Date . 3/26/12 0 Other Fees STATE PLBG DCA SURCHARGE STATE PLBG DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 62.00 62.00 .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: s8 (i )rn ell Zane 4 / PERMIT # 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 8 m L R Prep e Y fi S' Phone Number 38g -z 5 as Plumbing Company rh ► i S Hu JAI e P J 6 1 Me Office Phone 3g if i 34 9 Fax Co. Address: 55 010 Lj f /JO /.,/ <T � C (/ Di City en, ! i n h a 11 State f / Zip3 2 © 1 License Holder nt Pri : l t S tate Certification/Registration # (- FCO d !� c �) �'..��s�� Pv �'` l m �, g' 43 3 Notarized Signature of License Holder A Notary JAPubliNET c L, . PURVIS State of Florida Sworn and subscribed before me this c 3 day of 20 l / Commisslon#EE77030 r:... ,+,... . ® - My oomm. apices Apr. 10, 2018 .': ) Utij j