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Permit Plbg Repipe 2043 Duna Vista 2011 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 11-00002837 Date 11/ol/11 Property Address . . . . . . 2043 DUNA VISTA CT Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc REPIPE 16 FIXTURES ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ KURTZKE ROBERT E & KAREN S. ROLLAND REASH PLUMBING . 2043 DUNA VISTA CT. 11501 W COLUMBIA PARK DR #208 ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32258 (904) 260-7059 Permit . . . . . . PLUMBING PERMIT ---------------------------------- Additional desc . - REPIPE 16 FIXTURES Permit Fee . . . . 167 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/29/12 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 167 . 00 167 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 167 . 00 167 . 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: t5�70-�� 'ea'O't,/4 PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value $ l000 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: F-1 Sewer Replacement 1-1 Back Flow Preventer o Grease Interceptor(Trap) gallons(Requires 3 sets of plans) Lawn Sprinkler System-Number of Heads Ej Well SJRWD Well Completion Form. Completed-f—orm to be submitted to the—Building Department for final inspection." Ll Other wwmw� 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 authon to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name 11 1011 Aaw Phone Number 7C31— Plumbing Company A044*VO —Office Phone%Z�-70�a Fax ��_(:!�' Co. Address: AR,A/ city State'!E;_ zip c0i tff, n/Registration# License Holder(Print): Notarized Signature of License Holder M,e YP Notary Public State of Florkla Sworn and subscribed before me this day of. &j011f, Paul R Bagby m&l— 20 My Commission EE042408 Signature of Notary Public od,14 Expires 01/23/20 E 15