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Permit Plbg 900 #116 Plaza 2011 • Mar 08 10 12:54p Information SystemsCITY 0 904247_8845 p.1 PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Pb. (904) 247 -5525 Fax (904) 247 -5845 JOE' ADDRESS: 4 Piit If (0 PERMIT # NEW OR RENA cEivaNT INSTALLATION: Project Valve y TYPE OFFJXTURE QTY TYPE OF .1 Qry Bathtub Septic Tank & Pit Clothes Washer Shower - Dishwasher .Shower Pa Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavator Water Heater Other Fixtures Water Treating System RE-PIPE; PIPE OF Fa OTY TYPE OF Fixrui - 07=' 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 .JSCELLANEOtJS: o ;Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of pinn7t) ❑ Lawti Sprinkler System-usher of Heads ❑ Well * T . 1RWD Well Completion Form_ Completed form to be submitted to the Building Department for tea? inspection.** VOther. 12,44.,(401, c a3 (�:ru...` -F::: A.:k.•il vMk..:vfwef..:,.•l! .�sr[i. 1t<� *e wc.4 ^. Mt-Th5 Oh_is:.. ,sex• - :fnnr_n wmya4":- 'µN•'nh.*P !t..;. r .. S i�.f.YUY+' bevotnes void if work does not commence, within a six month p or work is suspended or abandoned for si months. I hereby certify that I have read tlis sppllcation and know the same to be true and correct. All pr vi ncns of laws and ordinances governing this work will be complied with whether speci^ed or ncr The permit does not give �� tb ority to viola a provisions of ary other state or local law regulation construction or the performance of construction. og�erty Owners NamEy''�'` C4 i Phone Number 24( 04 E'il =robing Company rjaOrd \t, Plumbing, inc. 7 Office Phone 1 - %,r:5 -) Fax "7;; -- ; 4f 88�. 0 ; 't ,o G Square e Court cc, Arlkiress: _ City State Zip (' 3/J's� t �j9 Certification/Registration # v L :License loo &der rant): �' State Certi r' ,�t,�,� � 2� �> ��� / �t. n„- Zea1 ��Qa�atraare of License Holder y /� S rorn and subsc bed before me this / day of �L!!�'ti 20 1/ • Signature of Notary Public �/D� AL, xo Notary Public State of Florida Neal R Major c- My Commission EE032510 � '�oi r� _ Expires 12/20/2014 rie ii4/0,- \\,, CITY OF ATLANTIC BEACH - 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002776 Property Address Date 10/14/11 PLAZA Application type description PLUMBING ONLY Property Zoning TO BE UPDATED Application valuation Application desc 1 FIXTURE 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 Issue Date .00 Expiration Date . Valuation 0 • 4/11/12 Other Fees STATE PLBG DCA SURCHARGE STATE PLBG DBPR SURCHARGE 2.00 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 62.00 62.00 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. ? CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 • c INSPECTION PHONE LINE 247 -5814 011 9 Application Number Property Address . . . • • 11- 00002776 Application type 900 PLAZA 116 Date 10/14/11 Application ype description PLUMBING ONLY Property Zoning TO BE _____ valuation . . UPDATED 0 Application desc 1 FIXTURE ------------------------------ ----------------- - - - - -- Owner ------------------------------------ --------- ---------- Contractor DAVID GRAY PLUMBING INC. 8850 CORPORATE SQUARE CT. JACKSONVILLE --------- ------- (904) 744 -7255 - - - - --- FL 32216 Permit . . PLUMBING PERMIT --------------- - -- Additional desc . ____ - ----- Permit Fee Issue Date 62.00 Plan Check Fee . Expiration Date Valuation .00 --------------- - - - - -- 4 /11/12 0 -------------------- - - - - -- -- ---------------- Other Fees ___ STATE PLBG DCA SURCHARGE SURCHARGE 2.00 STATE PLBG DBPR ------- ------- ___ 2.00 Fee summary Charged ____ ---------------- _ ___ Paid Credited Permit Fee Total ---- -- Due 62'00 62.00 .00 .00 Plan Check Total .00 . . .00 Other Fee Total Grand Total 4.00 4.00 .00 .00 66.00 66.00 00 .00