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Permit Water Heater 2016 Selva Madera 2011 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 11-00002858 Date 11/07/11 Property Address . . . . . . 2016 SELVA MADERA CT Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc water heater ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ GREENWALD, JOHN ATLANTIC COAST PLUMBING CORP. 2016 SELVA MADERA CT. 3653 REGENT BLVD #305 ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224 (904) 249-5381 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 62 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/05/12 ---------------------------------------------------------------------------- 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. Nov 07 11 02: 39p Susan Parrish 904-246-3673 P. 1 PLUMMING PERART APPLICATION CITY OF ATLAwic BEACH 900 Seminole Rd Atlantic Beach,FL 32233 Ph(904)247-5826 Fax(904)247-5845 JoB ADDRM: PERNM NEW O�(REP:L=ACENMNT INSTALLATION: Project Value S TYPE OF FLUVRE QTY 2)rpe oFFLrMJW QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Ehinkin Fountain Slop Sink 9 . Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavator y Water Heater Other rbtlms Water Treating System RE-PIPE: 71YE OF FUIMME QZ7 TYPEOFFMMAtE Q27 Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasbier Shower Pan Drb3ldng Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitcheo Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fbd=s Water Treafing System ?MSCELLANEOUS: [] Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor(Trap) gallorm(RKulres 3 sets of plans) 0 Lawn Sprinkler System-Number af Elea& 0 Well **=WD Well Completion Form. Completa—formto be submittedto 6—e—Bu—Jd—ing Department forfmal inVection." 0 Other Permitlxzomes void ifwork does notcommance wit"asLimonth perlod or Work is saspendedorabandoned for six manths.I bcrcby rutify that I h3veyead this applicaSon and know dke suwto be wim aDd carrect AU provisions oflaws and ordikmaces governing dim work wU1 be compUrd with whed2er spedfitd ornot The pcanit does not give w0hority to violate thtprovitdons ofa or stux or IoW law regWaion constructim or the performance ofcoustruction. .1 PhoneNumber 6%r7-1-1A1 Property Owners Name J4-1 mmy tplh-t-�t ;!' Office Phone Fax Plumbing Com- 14- Co. Address:-11161 ity ';�2L Statr'�-L/—zipl!?Z� License Holder(Print): A17'0-LIA State Certffication gi strad o n-4(1,P-4�0 50!�'7- 1-0 Notarized Signature ofLicense Holder V Sworn and sil Rcri befo m— s da)r m--)- Alvi'� -20Z/ DOW 0. W�(71HIE rr Notary pumic StaleofFlorida Sigmature ofNoUxy Public Apr 15,2013 J)D Spool My COMM-ExPi res Apr 15,2013 Lin W, Commission DD 880918 .....vv-- Bn IdPd Thrn-.4h Nalionai Notary Asin t piv. lnllp)js� 10 1,1�YnC'F, ()107 CI