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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 ---------------------------------------------------------------------------- Application desc SEPTIC TO SEWER ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BLAKELY CHRISTY FIRST COAST PLUMBING 1448 CAMELIA STREET 1651 MAYPORT RD ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 247-4419 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 62 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/15/12 ---------------------------------------------------------------------------- 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 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