Permit Plbg Septic to Sewer 1448 Camelia 2011 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00002904 Date 11/17/11
Property Address . . . . . . 1448 CAMELIA ST
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
SEPTIC TO SEWER
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Owner Contractor
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BLAKELY CHRISTY FIRST COAST PLUMBING
1448 CAMELIA STREET 1651 MAYPORT RD
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 247-4419
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/15/12
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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 4-
1414
JoB ADDRESS: PERNHT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oF FixTuRE QTY TYPE oF FLYTuRE QTY
Bathtub -i 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 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
MISCELLANEOUS:
• Sewer Replacement 0 Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
• Lawn Sprinkler System-Number of Heads El Well
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for fmal inspection.**
E:i 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 prov's"f any other state or local law regulation construction or the performance of construction.
Property Owners Name 11'Wak_tp'-L Phone Number
g Company 1651 Maypod RbAd
Plumbin,, -Off ice Phone Faxd-;/q
Co. Address: Atlantic Beach, FL 32233 Cit, State ZIP
License Holder(Print): State.Certification/Registration#
Notarized Signature of Lieense Adder '�Ia
—Swomandsub 4his day of 20//
JUUE YOUNG CHRISTY
MYC
OMMISSION#DD 873293
ignature of Notary Public
EXPIRES:July 24,2013
V. Bonded Thru Notary Public Unde t N,
L