Permit Plbg Replace sewer line 1619 Beach 2011 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
-5814
INSPECTION PHONE LINE 247
Application Number . . . . . 11-00002881 Date 11/14/11
Property Address . . . . . . 1619 BEACH AVE
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2400
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Application desc
REPLACE EXISTING SEWER LINE
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Owner Contractor
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MCGUINNESS, NEIL ROTO ROOTER SERVICES
1619 BEACH AVENUE 2028 W 21ST ST
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 354-7321
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Permit . . . . . . PLUMBING PERMIT
Additional desc . . REPLACE EXISTING SEWER LINE
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/12/12
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
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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
1013ADDRESS: A�Re_,ac\x\ PERmrr
NEW OR REPLACEMENT INSTALLATION: Project Value$*z/r/00_.
TYPE OF FiXTURE QTY TYPE OF FixTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pali
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 FrxTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drin"ig 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:
Irsewer Replacement [:] Back Flow Preventer o Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
7 Lawn Sprinkler System-Number of Heads El Well
SJRWD Well Completion Form. Completed form to be submitted to the Building Department,for final inspection.**
D 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 1 have read
:his 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
)r not. The perrr�t 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 \JIM we Sz� Phone Nuniber T 04- '��Q CJ
Ro\� %O%A
Office Phone J��A_�__Fax_js
PlumbingCompany
Co. Address: \o '�-��Azft city !�,nW4 State _��Zip Z�M
License Holder (Print): YC S�� tateCeitification/Registration4
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BAR@BI Xd ISNAI A.ADAMS -id subscribed before me this
Comm#DD0770121 �worn al day of SN)c,�\J eAo�t&-X 20
Expires 4122/2012
$ignature of Notary Public
Florida NOWFY Asm.,Inc
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