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
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Application desc
1 FIXTURE WATER HEATER
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Owner Contractor
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DONOR, PAT PONCE PLUMBING, INC.
378 SARGO ROAD 4642 COLLEGE ST
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32205
(904) 388-7502
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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 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
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