Permit Plbg Septic to Sewer 500 Orchid 2011 t ket
r�
cr s s CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
J3!3
Application Number 11- 00002719
Property Address Date 9/30/11
500 ORCHID ST
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
septic to sewer
Owner Contractor
HADDEN, THOMAS E. CHRISTY FIRST COAST PLUMBING
500 ORCHID STREET 1651 MAYPORT RD
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 247 -4419
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 62.00 Plan Check Fee .00
Issue Date Valuation 0
Expiration Date . . 3/28/12
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
Jos ADDRESS:
1 ' 51 -
PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value
TYPE OF FIXTURE
$
Q TYPE OFFIX7TI.RE Q
Bathtub
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
Lavato Water Connected Appliances
Other Fixtures Water Heater
Water Treating System
RE PIPE: •
TYPE OFFIXTURE Qom,
Bathtub TYPE OF FEATURE Q
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
Lavatory Water Connected Appliances
Other Fixtures Water Heater
Water Treating System
MISCELLANEOUS:
o Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor (Trap) gallons
o Lawn Sprinkler System Number of Heads (Requires 3 sets of plans)
0 ** RIYD Well Completion Form. Completed form Well
the g Department in
p be submitted epartment for final '
Other Wet-
spection.
Permit becomes void if work does not commence a six month period or work is suspended or abandoned for six months. I hereby
this application and know the same to be true and within correct. All
this
or not The provisions of laws and ordinances overnin t his y certify that I have read
permit does not give authority to violate the provisions t f any other state or local law g i regulation work will or the complied with whether specified
Property gelation construction or the performan f ce of construction
perty Owners Name • - e 1�� au*. a Phone Number o2.`-t _l_g
Plumbing Company �, St `1'IK ' G?(� p�1J i O fi ice Phone ` —
Co. Address: 51 1 p r Fax
- --, City Adat1t eClGhState Zip =��3
License Holder (Print): f r T
S • ;, ertification/Re 'stration # C
Notarized Signature of License . o , r r i ,• rrr
"' f JULIE YOUNG CHRISTY
� � � Sworn and subscrib before me this
�' day of 11
� MY COMMISSION II DD 873293 4 .�1.� 20
' ; ' , Bones Thin Not Ju 21, Nt n
j SignatUre ofNotarY Publi c t , '' ;
•