Permit Plbg Water Heater 487 Royal Palms 2011 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
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Application Number . . . . . 11-00002903 Date 11/16/11
Property Address . . . . . . 487 ROYAL PALMS DR
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
1 FIXTURE WATER HEATER
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Owner Contractor
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JACOBS, TERRY A J MOREL PLUMBING INC
487 ROYAL PALMS DRIVE 8915 CASTLE ROCK DR
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32221
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/14/12
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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 PFRMIT APPLICATION
CITY OF ATLANTIC BIEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845
JoB ADDRESS: 3 7 va-Z 127117)s Ar k1anhL6f2c..b,.1--i_ PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ :�LW,06
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 FrxTURE QTY TYPE bF 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:
--I Sewer Replacement Ei Back Flow Preventer [I Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Lawn Sprinkler System-Number of Heads Li Well
SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
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 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 authority to violate the provisions of any other state or local law regulation construction or the performance of construction,
Property Owners Name. _r-e_rr1V a C_0'6'� Phone Number 0q-,,2q&-3a2_"T
Plumbing Company AJ . M6(rd A oMbW , I OC, Office Phone �Qq 3 7q-SM
? Fax_qQq_-3_7'4-_9qL
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Co. Address: . C ity 11 C�_501)V1 Ile— State a Zipa-�J-,V
License Holder(Print): Wfd' State Certification/Registration#4��
Notarized Signature of License Holder
R*AEL CASTRO42; rorn and subscribed before me this day 0_&
EXPIRES:October 9,2AI.5
kr,MThruWNawy*mwSnature of Notary Public
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