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Permit Plbg Water heater 378 Sargo 2011 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 11-00002902 Date 11/16/11 Property Address . . . . . . 378 SARGO RD Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1 FIXTURE WATER HEATER ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ DONOR, PAT PONCE PLUMBING, INC. 378 SARGO ROAD 4642 COLLEGE ST ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32205 (904) 388-7502 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 62 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/14/12 ---------------------------------------------------------------------------- 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 ONLV IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 20**08 1735 AGS INSTALLATIONS 9042470535>>+1.904.592.6590 P 1/1 PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904)247-5826 Fax(904)247-5845 JOB ADDRESS;_ 3-29 54"a 9�� dL - -3 NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE OF FixruRE QTY TYPE oF FixruRE QTY Bathtub Septic Tank& Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain S'o ink Floor Drain ThreeSCompartmcnt Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Brftkers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System RE-PIPE: TYPE oF FixruRE QTY TYPE OF FWURE 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: 0 Sewer Replacement C3 Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of pt2ns) o Lawn Sprinkler System-Number of Heads — c Well **,VRWD Well Complelion Form.Completea form to be submitted to the Building Department for final inspection.** i i Other Permit bcwmcs 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 truc and correct. All provisions of laws and ordinances governing this work will be compiled with whether specified or not. The pennit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction, Phone Number Property Owners Name => I Office Phone,3 1&12--�-sb. 3� Plumbing Company :P—>1�,D­ Jax Co.Address: q city 13 C State-�:4- Zip License Holder(Print)- --OqCx-ne-� <3-� State Certification/Registration QV--C- 147--7�51 Notarized Signature ofLicense Holder Sworn and subscribed before me th A—U- 0, 14-1 NA MATTMOO Signature of Notary Public # 2014 EXJ'JRES Octo -0153 FioridaN (4